Skip to main content

Full text of "Morbid fears and compulsions; their psychology and psychoanalytic treatment"

See other formats 


Google 


This  is  a  digital  copy  of  a  book  that  was  preserved  for  generations  on  Hbrary  shelves  before  it  was  carefully  scanned  by  Google  as  part  of  a  project 

to  make  the  world's  books  discoverable  online. 

It  has  survived  long  enough  for  the  copyright  to  expire  and  the  book  to  enter  the  public  domain.  A  public  domain  book  is  one  that  was  never  subject 

to  copyright  or  whose  legal  copyright  term  has  expired.  Whether  a  book  is  in  the  public  domain  may  vary  country  to  country.  Public  domain  books 

are  our  gateways  to  the  past,  representing  a  wealth  of  history,  culture  and  knowledge  that's  often  difficult  to  discover. 

Marks,  notations  and  other  maiginalia  present  in  the  original  volume  will  appear  in  this  file  -  a  reminder  of  this  book's  long  journey  from  the 

publisher  to  a  library  and  finally  to  you. 

Usage  guidelines 

Google  is  proud  to  partner  with  libraries  to  digitize  public  domain  materials  and  make  them  widely  accessible.  Public  domain  books  belong  to  the 
public  and  we  are  merely  their  custodians.  Nevertheless,  this  work  is  expensive,  so  in  order  to  keep  providing  this  resource,  we  liave  taken  steps  to 
prevent  abuse  by  commercial  parties,  including  placing  technical  restrictions  on  automated  querying. 
We  also  ask  that  you: 

+  Make  non-commercial  use  of  the  files  We  designed  Google  Book  Search  for  use  by  individuals,  and  we  request  that  you  use  these  files  for 
personal,  non-commercial  purposes. 

+  Refrain  fivm  automated  querying  Do  not  send  automated  queries  of  any  sort  to  Google's  system:  If  you  are  conducting  research  on  machine 
translation,  optical  character  recognition  or  other  areas  where  access  to  a  large  amount  of  text  is  helpful,  please  contact  us.  We  encourage  the 
use  of  public  domain  materials  for  these  purposes  and  may  be  able  to  help. 

+  Maintain  attributionTht  GoogXt  "watermark"  you  see  on  each  file  is  essential  for  informing  people  about  this  project  and  helping  them  find 
additional  materials  through  Google  Book  Search.  Please  do  not  remove  it. 

+  Keep  it  legal  Whatever  your  use,  remember  that  you  are  responsible  for  ensuring  that  what  you  are  doing  is  legal.  Do  not  assume  that  just 
because  we  believe  a  book  is  in  the  public  domain  for  users  in  the  United  States,  that  the  work  is  also  in  the  public  domain  for  users  in  other 
countries.  Whether  a  book  is  still  in  copyright  varies  from  country  to  country,  and  we  can't  offer  guidance  on  whether  any  specific  use  of 
any  specific  book  is  allowed.  Please  do  not  assume  that  a  book's  appearance  in  Google  Book  Search  means  it  can  be  used  in  any  manner 
anywhere  in  the  world.  Copyright  infringement  liabili^  can  be  quite  severe. 

About  Google  Book  Search 

Google's  mission  is  to  organize  the  world's  information  and  to  make  it  universally  accessible  and  useful.   Google  Book  Search  helps  readers 
discover  the  world's  books  while  helping  authors  and  publishers  reach  new  audiences.  You  can  search  through  the  full  text  of  this  book  on  the  web 

at|http  :  //books  .  google  .  com/| 


»   '       • 


I 

I 


'MORBID  FEARS 
AND  COMPULSIONS- 

TBEIR  PSYCHOLOGY  AND 
PSYCHOANALYTIC  TBEATMENT 

BY 

H.  W.  FRINK,  M.D. 

AMistut  PrefMnr  of  NeatolDn  <d  CotdcII  L'nlTenJtr  Uadkal 

Csllccc  AdjDDCt  AMictut  NenroloKlrt  to  Bdlenw  HiMplUl, 

Si-prMldent  of  the  New  Vork  Pirctuuklrtic  SociMr. 

Saoctarr  of  tba  Amerieaii  PtrebopsllMloclol 

Ainelatian.  Uambar  of  tbo  Ameriaui 

Pi^bouulytlc  ABoelatiOD.  otc 

WITH  AN  INTRODUCTION  BT 


NEW  YORK 

HOFPAT,  YARD  AND  COMPANY 

1918 


'RC34-3 

BI^LOOT 

O 


CopFright.  1918.  bf 
If OPPAT.  TAU>  AND  OOMPANT 

F^IUhed,  Marehs  MB 


•  •  • 


•    : .'    .* 


•  .         •  •  :     •   • ♦   . 


•   • 


TO 

CHARLES  LOOMIS  DANA,  A.H.,  M.D.,  LL.D. 

or  NnnuM^MT  nr  Counnx  Unrnfrrr 
MiDieAL  Couaai 

THIS  BOOK 

IS 

ORATirULLT  DIDICATID 


37619,1 


INTRODUCTION 

The  day  has  f ortnnately  gone  by  when  the  far- 
reaching  investigations  associated  with  the  name 
of  Sigmond  Frend  need  to  be  introduced^  as  if  for 
the  first  time,  to  any  such  circle  of  readers  as  that 
to  which  this  book  is  likely  to  appeal  Indeed,  so 
familiar  have  men  grown  with  the  more  salient 
features  of  the  so-called  psychoanalytic  move- 
menty  and  so  pronoimced  is  the  interest  which  it 
has  evoked,  that  one  feels  a  sense  of  lack,  if,  on 
looking  through  a  volume  or  a  magazine  where 
hmnan  motives  are  discussed,  one  does  not  find 
some  reference  to  the  doctrines  here  at  stake. 

That  this  increased  and  growing  interest  is  not 
due  to  curiosity  alone  is  shown  by  the  fact  that 
many  eminent  scientific  men — ^psychologists,  biol- 
ogists and  educators — ^have  used  Freud's  general- 
izations largely,  in  connection  with  their  own  in- 
quiries. Not  only  have  these  men  published  books 
and  papers  of  which  the  psychoanalytic  movement 
was  the  text,  but  they  have  made  it  the  basis  of 
discussion  in  academic  courses. 

This  is  an  important  indication.  For  these  able 
men  stand  as  representatives  of  the  so-called 
"normal''  members  of  the  community;  it  is  **nof- 
m^"  psychology,  both  individual  and  social,  and 


vi  INTRODUCTION 

' 'normal''  life  processes  and  the  education  of 
'* normal''  people  that  they  study. 

But  what  is  '^ normal/'  and  to  what  extent  is  it 
possible  to  distinguish  it  from  what,  for  one  or  an- 
other reason,  we  call  *' abnormal"! 

Much  has  been  written  on  this  point,  and  prac- 
tically always  the  answer  to  the  above  question 
has  been  that  there  are  no  means  of  distinguishing 
these  two  states.  That  which  goes  by  the  name 
of  ''evil"  or  "disease"  fmds  its  analogue  in  the 
instability  that  is  inseparable  from  life  and  prog- 
ress ;  and  the  forms  that  disease  takes  in  the  so- 
called  "pervert"  or  the  nervous  invalid,  or  even 
the  criminal,  do  but  represent,  in  an  accentuated 
form,  tendencies  of  which  traces  are  to  be  dis- 
covered in  the  history,  and  as  an  element  in  the 
make-up,  of  every  member  of  the  community. 
There  is  then  good  reason  why  all  those  who  wish 
to  understand  the  weaknesses  of  society  and  work 
for  the  betterment  of  the  race,  should  take  inter- 
est in  this  movement. 

What  is  it  (over  and  above  external  conditions y 
that  causes  the  terrible  misery  in  our  social  life, 
of  which  the  dramatists  and  novelists  have  so 
much  to  say  and  which  breaks  out  in  the  form  of 
strikes  and  anarchy,  and  lies  widespread,  just  be- 
neath the  surface,  in  the  form  of  superstitions, 
depressions,  unreasonable  fears,  or  of  "hatred, 
malice  and  all  uncharitableness"f  Why  is  it  that 
soiQe  persons  are  so  much  more  overwhelmed  than 
others  by  the  recitals  of  the  horrors  of  the  warf 


INTBODnCTION  vii 

People  afflicted  with  these  tendencies  present,  f re- 
qnently,  the  same  front  to  the  community  that  is 
presented  by  the  happiest  and  most  prosperous 
of  men.  But  they  present  this  front,  in  many 
cases,  not  from  deliberate  and  reasoned  choice, 
but  because,  separated  in  feeling  from  their  as- 
sumedly  happier  or  more  successful  fellows,  they 
feel  impelled  to  seek,  as  if  through  a  sort  of  '^pro- 
tective coloration,"  to  preserve  every  outward 
sign  that  is  possible,  of  good  health,  good  fellow- 
ship and  success.  Close  observers  realize  more 
or  less  of  what  is  going  on  with  such  persons,  and 
the  more  intelligent  of  these  observers  see  also 
that  the  facts  and  doctrines  that  have  been  brought 
out  through  the  psychoanalytic  movement  afford  a 
better  explanation  of  these  situations  than  is  pro- 
vided in  any  other  way. 

The  present  book  does  not  make  it  one  of  its 
main  purposes  to  take  up  these  social  problems ; 
bnt  the  author  has  a  keen  sense  for  the  analogies 
to  which  I  have  referred,  and  in  both  parts  of  his 
treatise — ^that  is,  in  the  part  in  which  the  history 
and  fundamentid  doctrines  are  laid  down,  and  in 
that  in  which  the  compulsions  and  obsessions  are 
more  specifikudly  studied — ^he  gives  illustrations 
which  every  social  student  may  well  take  to  heart, 
of  the  varied  and  significant  modes  of  action  of 
men's  unconscious  motives. 

And  yet  so  difficult  is  the  subject ;  so  hard  is  it 
to  realfy  grasp  these  elusive  motives  that  play 
80  large  a  part  in  all  our  lives,  to  exchange  a 


viii  liTTEODirCTION 

'^knowledge  about"  them  for  a  real  '^acqaaint- 
anoe  with"  them,  that  there  will  be  room  and  wel- 
come^  during  many  years  to  come,  for  any  book 
that  deals  consciously  and  clearly  with  the  prob- 
lems here  involved. 

The  present  volume  fulfills  these  requirements 
admirably  within  the  limits  which  the  author  sets 
for  himself,  and  inspires  confidence  by  evidences 
of  abundant  knowledge  and  of  conscientiousness 
in  forming  judgments.  Dr.  Frink  is  evidently 
writing  for  physicians  and  those  who  are  ready 
to  take  the  physician's  point  of  view.  This  has 
always  been  Freud's  method,  also;  and  in  follow- 
ing it, — ^that  is,  through  keeping  before  his  mind 
that  he  would  choose  for  his  imagined  audience 
those  only  who  were  ready  to  gaze  at  the  truth 
without  dirinking, — ^he  was  able  to  cultivate  his 
power  of  accurate  observation  to  a  remarkable 
degree.  If  his  statements  became  now  and  then 
too  blunt,  or  too  one-sided,  or  extreme,  that  fact 
should  and  will  be  forgiven,  when  it  is  borne  in 
mind  that  unless  he  had  trained  himself  to  be 
keenly  alive  to  the  presence  of  certain  special  mo- 
tives rather  than  a  judicial  evaluer  of  all  motives, 
the  psychoanalytic  movement  would  never  have 
attained  the  position  that  it  holds. 

This  is  an  important  consideration  in  Freud's 
intellectual  history  and  that  of  the  most  stalwart 
of  his  followers.  If  their  work  has  been  marked 
by  ** defects,"  they  have  shown,  as  a  rule,  ** quali- 
ties" enough  to  justify  these  defects.    It  has 


^ 


INTEODnCTION  ix 

often  been  urged  against  Freud,  for  ezampley  that 
his  analyses  of  characters  in  history  and  fiction, — 
such  as  those  of  Leonardo,  Hamlet  and  (Edipus, 
— give  a  distorted  idea  of  their  lives  and  person- 
alities. In  itself  this  criticism  is  just,  and  analo- 
gous comments  can  be  made  on  the  psychoan- 
alytic movement  as  a  whole.  But  they  should  be 
made  in  the  light  of  what  I  have  just  now  said. 
The  time  has  perhaps  arrived,  it  is  true,  when  the 
leaders  of  this  movement  should  be  called  upon 
to  cease  being  nlonographic,  and,  instead  of  this, 
to  take  their  places,  consciously,  as  students  of 
the  mind  and  its  sources  of  energy  from  all  points 
of  view,  even  if  they  continued  to  emphasize  espe- 
cially one  aspect  of  these  matters.  And  yet,  even 
now,  it  must  be  kept  in  view  that  knowledge  moves 
forward  by  a  zigzag  path,  and  that  the  most  im- 
portant thing,  where  the  contributions  of  men  of 
genius  are  in  question,  is  that  nothing  of  value 
shall  be  lost  of  what  they  have  to  give.  The 
errors  of  omission  of  important  men  and  im- 
portant movements  can  easily  be  forgiven. 

This  consideration  should  be  especially  borne  in 
mind  when  one  is  dealing  with  the  sex  problem, — 
which  Dr.  Frink  discusses  clearly,  in  a  simple  and 
straightforward  manner,  proposing  at  the  same 
time  a  new  name,  in  order  to  call  attention  afresh 
to  the  very  important  generalization,  that  when 
one  uses  the  word  '^sexual"  one  should  have  in 
mind  all  the  connotations  that  go  with  the  word 
'4ove,"  understood  as  he  defines  it. 


X  iNTRODnOTION 

It  is  tme  that  other  emotions  are  '^ repressed" 
besides  those  classifiable  as  sexual.  But  the  point 
mainly  at  stake  is  the  pragmatic  one  that  the 
sexual  emotions  involve  a  peculiarly  large  num- 
ber of  dominant,  unreasoning  passions,  of  a  sort 
that  each  individual  is  least  willing  to  acknowl- 
edge (or  else,  it  may  be,  is  over-zealous  in  assert- 
ing) and  the  subtle  signs  of  which  it  is  especially 
important  that  the  student  of  medicine  should 
train  himself  to  detect. 

Having  said  this  much  about  those  character- 
istics of  Freud's  work  which  perhaps  more  than 
any  others  have  laid  its  author  open  to  criticism^ 
and  having  thereby,  I  trust,  made  it  clear  that  I 
am  not  inclined  to  deal  with  Fteud's  conclusions 
in  anything  but  a  friendly  spirit,  I  shall  claim  the 
privilege  of  indicating  some  of  the  points  with  re- 
gard to  which  I  think  his  critics  are  in  the  right ; 
or,  to  speak  more  exactly,  to  indicate  the  direc- 
tions in  which,  as  it  seems  to  me,  the  boundaries 
of  his  work  may  profitably  be  widened. 

Freud  was,  and  is,  above  all  things,  a  man  to 
whom  the  exact  methods  of  natural  science  were 
very  dear,  as,  in  his  estimation,  the  only  reliable 
means  of  investigation  even  in  matters  of  per- 
sonal motive  and  conduct.  In  this  respect  he  be- 
longs, of  course,  to  that  large  class  of  persons 
whose  labors  are  absolutely  indispensable  to  the 
evolution  of  human  knowledge;  and  Dr.  Frink's 
expressions  of  opinion  make  it  clear  that  he  would 
wish  to  be  classified  in  the  same  group.    But  there 


INTBODUCTION  xi 

are  also  many  mei^  whose  voices  never  have  been, 
and  never  can  be,  sil^iced,  who  feel  convinced 
that  the  dicta  of  the  natural  scientists, — ^that  is,  of 
those  who  wonld  eventually  refer  everything  back 
to  the  laws  of  chemistry  and  physics, — are  not  to 
be  allowed  to  have  the  last  word.  There  are,  in- 
deedy  many  members  of  the  scientific  group  itself, 
who  have  testified  to  their  belief  in  this  fact. 
Such  persons  not  only  feel  it  clear  that  these 
natural  laws  do  not  explain  all  the  phenomena  of 
life ;  fhey  feel  also  that  one  of  the  most  interesting 
outcomes  of  scientific,  and  still  more  of  logical  in- 
quiry, is  the  fact  that  these  sciences  seem  to  prove 
not  only  that  the  laws  which  they  recognize  as 
valid  are  not  only  themselves  limited  in  their  ap- 
plication, but  also  that  they  actually  point  to  the 
existence  of  forms  of  energy  which  they  are  pow- 
erless to  describe. 

The  fact  that  Freud  was  so  devoted  to  the  scien- 
tific method,  and,  from  the  same  standpoint,  so 
devoted  to  the  belief  that  mental  phenomena  are 
just  as  much  subject  to  infiexible  laws  of  causa- 
tion as  physical  phenomena,  and,  in  fact,  that  the 
causation  in  the  two  cases  is  virtually  of  the  same 
sort,  would  perhaps  have  done  no  harm  had  it 
spent  itself  (as  it  did  to  a  considerable  extent)  in 
leading  him  to  measure  and  define  the  degree  to 
which  this  doctrine  represents  the  truth.  But, — 
unfortunately,  as  it  seems  to  me, — ^he  went  fur- 
ther than  this,  and  in  spite  of  disclaiming,  as  he 
has  always  done,  any  obligation  to  adopt  a  general 


xii  INTEODnCTION 

attitude  toward  the  '^ ultimate  nature  of  things/' 
in  a  philosophical  sense,  he  does  nevertheless  do 
this  very  thing  in  his  claim  that  we  live,  body  and 
soul,  in  a  deterministic  world,^  a  world  in  which 
the  last  word  belongs  to  physical  science. 

No  one  could,  of  course,  deny  him  the  right  to 
this  opinion ;  but  if  it  is  held,  it  should  be  justified 
through  the  presentation  of  evidence,  on  his  part, 
of  having  taken  all  the  arguments  of  both  sides 
into  account;  and  this  evidence  Freud  has  not 
given. 

Dr.  Frink  brings  the  matter  to  a  clear  issue  in 
his  thesis  (which  is  quite  in  accord  with  Freud's 
doctrine)  that  every  individual  when  looked  at 
from  the  standpoint  of  his  childhood  must  be 
recognized  as  following  two,  and  only  two,  tenden- 
cies,— ^those  namely  of  self  preservation  and  of 
race  preservation.  This  is  the  accepted  formula 
among  perhaps  the  majority  of  biologists.  But 
unless  the  word  ** preservation"  is  interpreted  in 
such  a  way  as  to  include  far  more  than  the  simple 
preservation  of  life, — that  is,  unless  it  is  admitted 
that  from  first  to  last  the  highest  attributes  of  the 
human  being  are  thought  of  as  virtually  present, 
(as  in  the  form  of  what  is  vaguely  described  as 
"free  will,"  existing  as  a  partially  guiding  influ- 
ence),— ^I  should  not  feel  at  liberty  to  grant  the 
claim. 

The  antithesis  is  between  those  who  look  on 

lE.  g.  see  statentents  of  this  sort  in  his  paper  entitled  Totem 
and  Tabu.    TranBlation  Totem  and  Taboo^  N.  Y.,  1918. 


INTBODnOTION  xiii 

what  (for  want  of  a  better  term)  one  must  call  the 
higher,  more  spiritual  manifestations  of  life,  as 
definable  in  terms  of  chemistry  and  physios,  as 
ordinarily  conceived  of,  and  those  who  believe  that 
chemistry  and  physics  are  to  be  defined  in  terms 
of  these  higher  manifestations  of  life.  The  sig- 
nificance for  therapeutics  of  the  problem  here  in- 
volved is  very  dear. 

The  next  point  which  seems  to  me  important 
has  reference  to  the  scope  of  psychoanalytic  work. 
Freud,  with  his  keen  sense  of  the  difficulties  and 
dangers  lying  in  the  path  of  the  psychoanalytic 
movement,  has  strongly  maintained  that  psycho- 
analysts would  never  do  their  best  in  the  direc- 
tion of  keeping  the  movement  free  from  degra- 
dation, or  of  helping  their  patients  to  make  their 
memories  and  power  of  reasoning  penetrate  into 
the  depths  of  their  repressed  experiences,  unless 
they  made  these  outcomes  virtually  the  sole  object 
of  their  treatments  and  resisted  the  temptation 
to  act  as  mentors  and  advisors  with  reference  to 
specific  social  difficulties  of  the  hours.  In  spite 
of  the  apparent  insistence  and  importance  of  the 
patient's  immediately  present  problems,  Freud 
held  that  the  problems  which  they  were  really 
thinking  of  and  needed  most  of  all  to  solve,  were 
those  related  to  their  repressed  complexes. 

On  similar  grounds  he  has  strenuously  objected 
to  the  introduction  of  ethical  considerations,  or 
aiming  for  ethical  results.  While  believing  that  a 
psychoanalytic  treatment  was  in  a  high  degree  a 


xiv  INTRODUCTION 

form  of  education,  he  has  felt  that  the  physician's 
part  was  only  that  of  Vergil,  in  Dante's  cele- 
brated journey  through  Hell,  Purgatory,  and 
Paradise ;  not  at  all  that  of  Beatrice.  The  patient 
comes  to  the  physician,  let  us  say,  skilled  in  the 
art  of  self-deception,  and  suffering  under  a  self- 
wielded  lash.  The  physician's  task  is  to  see  that 
he  becomes  undeceived,  by  helping  him  to  bridge 
the  wide  chasm  between  his  logical  consciousness 
and  his  unlogical  phantasies.  When  this  task  is 
accomplished,  and  thus  a  better  understanding  of 
himself  is  brought  about,  and  when  his  fears  or 
compulsions,  or  such  other  symptoms  as  he  may 
have  presented,  have  been  dissipated  by  a  thor- 
oughgoing psychoanalysis,  the  physician's  task, 
so  Freud  would  say,  is  ended.  The  physician  is 
under  no  obligation  to  inquire  what  use  the  pa- 
tient makes  of  his  newly  acquired  freedom,  or  to 
lead  him  further  on  the  path  of  sublimation. 

r  As  against  this  view  of  the  duty  of  the  psycho- 
analyst, which  I  trust  is  fairly  stated,  it  is  reason- 

\  able  to  urge  that  whatever  the  actual  so-called 
*' symptoms"  are  with  which  the  patient  comes 
to  his  physician,  he  brings  inevitably  the  virtual 
symptom  which  consists  in  an  incapacity  to  ex- 
press through  his  life  the  recognition  of  his  social 
obligations  and  possibilities  as  an  integral  por- 

Ltion  of  the  social  organism.  Yet  these  obliga- 
tions and  possibilities  are  his  by  birthright. 
From  this  standpoint  a  psychoanalytic  treatment 
is  not  logically  complete  until  the  patient  so  thor- 


INTBODnCTION 

onghly  understands  himself  that  he  is  not  only 
able,  but  feels  himself  compelled  to  see  himself 
and  his  social  obligations  in  the  best  form  possible 
to  him.  Looked  at  in  this  way  the  functions  of 
Vergil  and  Beatrice  coalesce. 

If  this  mode  of  looking  at  the  matter  is  correct, 
the  psychoanalyst  of  the  future  must  himself  be 
a  person  of  broad  and  ethical  outlook,  and  yet 
must  learn  to  see  and  avoid  the  danger  that  he 
may  lose  sight  of  his  psychoanalytic  ideals  and 
forget  the  technique  of  psychoanalytic  practice. 
Is  this  possible?    I  think,  Yes. 

IMnally  it  is  well  known  to  all  those  who  have 
followed  the  literature  of  this  subject,  that  many 
persons  who  have  been  students,  (and  some  of 
them  well-wishers)  of  the  psychoanalytic  move- 
ment, claim  that  Freud  has  made  too  much  of  the 
sexual  motivation  of  men's  conduct  and  of  the 
sexual  content  of  their  unconscious  yet  active  men- 
tal life.  A  prominent  representative  of  a  view 
akin  to  this  is  Alfred  Adier  of  Vienna,  who  ap- 
proaches the  subject  of  conduct  from  a  somewhat 
special  standpoint,  though  one  that  Freud  himself 
has  never  failed  to  recognize.  He  calls  attention 
to  the  striking  difference  between  individuals  as 
they  start  on  their  course  of  life,  in  that  some  are 
handicapped  by  defects,  of  which  the  most  typical 
are  weaknesses  in  certain  organs  and  their  func- 
tions. In  consequence  of  these  defects  the  per-* 
son's  life  is  spent  partly  in  an  instinctive  seeking 
for  compensation, — which  may  become   **over- 


xvi  INTRODUCTION 

compensation/' — ^partly  in  an  effort  to  escape  re- 
sponsibilities whicli  he  feels  he  cannot  meet. 

It  is  not  my  place  or  desire  to  enter  here  on  any 
adequate  discussion,  or  even  statement,  of  the 
situation  raised  by  Adler.  I  would  only  say  that 
in  my  opinion  it  does  represent  a  more  biological 
mode  of  looking  at  tHe  causes  of  men's  conduct, 
which  at  times  has  its  convenience,  and  which,  to 
say  the  least,  is  not  incompatible  with  Freud's 
doctrines.  It  is  unfortunate  that  his  emphasis — 
which  is  a  valuable  one — could  not  have  been  given 
without  his  having  found  it  necessary  to  attack 
Freud's  fundamental  doctrines,  which  have  been 
of  such  immeasurable  value.  But  behind  both  of 
these  modes  of  approach,  there  lies  the  immensely 
important  fact  that  man  is  a  social  animal  and 
that  he  has,  of  necessity,  ideals  of  life  and  con- 
.  duct  and  the  good,  which,  in  a  sense,  transcend  hia 
/  recognition  of  weakness,  temptation  and  defect 

James  J.  Putkah. 


AUTHOR'S  NOTE 

There  are  three  classes  of  readers  to  whom  a 
book  on  psychoanalysis  might  be  of  interest.  In 
the  first,  would  be  tiiose  entirely  mif  amiliar  with 
Freudian  psychology  and  who  wish  to  make  a  first 
acquaintance  with  the  subject;  in  the  second, 
those  who  already  know  something  about  psycho- 
analysis and  are  desirous  of  learning  more,  with 
the  intention  in  some  instances  of  using  it  in  prac- 
tice. The  third,  and  by  far  the  smallest  class, 
would  be  made  up  of  those  having  considerable 
training  and  experience  in  psychoanalytic  work 
and  whose  interest  therefore  would  be  in  the  finer 
details  of  theory  and  technique  and  in  the  more 
elaborate  reports  of  analyzed  cases.  It  is  to  the 
second  class  of  these  readers  that  this  book  wiU  be 
most  likely  to  appeal. 

That  such  is  the  case  is  not  entirely  in  accord- 
ance with  the  plans  I  had  in  mind  on  beginning 
to  write  the  book.  The  ^chapters  that  are  pre- 
sented here  were  intended,  according  to  the  orig- 
inal scheme,  to  serve  a  semi-introductory  func- 
tion in  preparation  for  two  final  and  more  highly 
tedmical  chapters  wherein  an  elaborately  ana- 
lysed case  and  the  more  intricate  details  of  the- 
ory and  practice  would  be  considered.  But 
partly  because  I  found  unexpected  difficulties  in 
the  way  of  compressing  the  case  report  sufficiently 

zvii 


xvui  AUTHOR'S  NOTE 

to  conform  to  the  physical  limits  set  for  this  book^ 
and  partly  from  the  reflection  that  such  matter 
would  have  its  interest  for  a  different  and  smaller 
audience  than  the  one  to  which  the  present  chap- 
ters might  appeal,  I  eventually  decided  to  use 
this  clinical  material  as  the  basis  for  a  second  vol- 
umCy  supplementary  to  this  one,  and  in  which  also 
the  question  of  analytic  technique  could  be  more 
suitably  considered. 

I  am  not  greatly  in  sympathy  with  the  theor- 
etical and  technical  innovations  in  psychoanalysis 
introduced  rather  recently  by  the  schools  of  Jung 
and  of  Adler,  and  the  views  set  forth  in  this  book 
are  intended  to  represent  the  purely  Freudian 
doctrines  in  so  far  as  I  am  able  to  understand 
and  interpret  thenL  In  some  of  the  more  highly 
theoretical  parts  of  the  present  volume  I  have 
followed  Freud's  writings  very  closely,  not  hesi- 
tating at  times  even  to  borrow  his  words.  Be- 
lieving, however,  that  one  may  get  a  clearer  view 
of  involved  material  by  looking  at  it  from  more 
than  one  angle,  I  have  ventured  to  introduce,  in 
some  portions  of  the  book,  what  amounts  to  a 
hybrid  behaviorisnL  In  doing  this  I  have  felt 
some  misgivings,  for  behaviorism  is  a  field  in 
which  I  have  little  reason  for  feeling  sure  of  my- 
self, and  I  am  aware  that  my  efforts  to  produce 
clarity  may  perhaps  result  in  confusion. 

Some  of  the  material  utilized  in  this  book  I 
have  published  before.  That  which  constitutes 
Chapter  VI  is,  except  for  some  minor  changes 
and  omissions,  as  it  originally  appeared  in  the 
Psycho<malytic  Review,  under  the  title,  **A  Psy- 


AUTHOR'S  NOTE  xix 

ohoanalytic  Study  of  a  Severe  Case  of  Compul- 
sion Neurosis/'  A  large  part  of  the  chapter  on 
dreams  is  taken  from  two  papers  entitled, 
"Dream  and  Neurosis/*  and,  **0n  Freud's  The- 
ory of  Dreams,"  which  were  published  in  the 
Interstate  Medical  Journal,  and  American  Medi- 
cine, respectively.  The  two  analyses  of  name- 
forgetting  are  taken  from  "Three  Examples  of 
Name-Forgetting,*'  and  "Some  Analyses  in  the 
Psychopathology  of  Everyday  Life,"  which  ap- 
peared in  the  Journal  of  Abnormal  Psychology. 
I  wish  to  express  my  indebtedness  to  these  jour- 
nals for  permission  to  reprint  this  material.  I 
owe  a  similar  acknowledgment  to  the  New  York 
Times,  the  New  York  Tribune,  and  the  Louisville 
Times,  by  whose  courtesy  the  cartoons  used  in 
Chapter  m  are  reproduced. 

In  reporting  clinical  material  throughout  this 
book  I  have  made  such  minor  changes  or  omis- 
sions as  seemed  to  me  necessary  to  conceal  the 
identity  of  the  patients  in  question,  but  none  of 
these  alterations  are  serious  enough  to  affect  the 
scientific  value  of  the  reports. 

The  bibliographies  for  the  various  chapters  in 
this  book  are  intended  to  serve  as  general  refer- 
ences and  to  indicate  lines  for  collateral  reading. 
They  are  not  intended  to  be  at  all  exhaustive. 
For  more  complete  lists  of  psychoanalytic  litera- 
ture the  reader  is  referred  to  those  given  in  the 
Jahrbuch  der  Psychoanalyse,  Bd.  VI.,  1914.  Spe- 
cific references  are  given  in  some  parts  of  this 
book  but  omitted  in  other  parts,  as  for  instance, 
in  the  Second  Chapter,  where  to  give  them  would 


AUTHORS  NOTE 

involve  referring  almost  every  paragraph  to  the 
same  small  list  of  authoritative  works. 

In  condnsion  I  wish  to  express  my  great  in- 
debtedness to  Mr.  Wilfrid  Lay  for  his  assistance 
in  the  preparation  of  this  book. 

H.  W.  Fbink. 


CONTENTS 

CHAPTER  I 
The  Sexual  Synthesis 1 

Sezual  origin  of  functional  neuroses  suspected  by  the 
ancients  given  a  scientific  basis  by  Freud.  Meaning  of 
the  term  aesmoL  The  individual  as  a  separate  entity 
and  as  a  member  of  the  race.  The  instincts  preserva- 
tive of  individual  and  of  race — ^hunger  and  sex.  Every 
human  feeling  traceable  to  one  of  tiieae  two.  Everything 
connected  wiui  hunger  on  the  one  hand  and  reproduction 
on  the  other  forming  two  groups,  the  second  correspond- 
ing to  the  broad  use  of  the  word  sexual.  Self  preserva- 
tive instinct  and  holophilic  instinct.  The  parallel  be- 
tween higher  and  lower  is  reproduced  in  the  parallel  be- 
tween infant  and  adult  and  first  adequately  recognized 
by  Freud.  Adult  sexuality  a  composite  of  impulses 
already  present  in  the  infant.  All  physical  sexual 
machinery  present  in  infancy,  needing  only  the  new 
secretions  of  adulthood  to  set  it  in  motion.  Three 
phases  of  development  of  human  sexuality:  1.  infantile 
or  pre-inhibltory,  2.  childhood  and  3.  adult.  Infantile 
holophilic  phenomena.  Erogenous  zones  and  pleasure 
from  their  stimulation.  Pleasure  incidental  to  alimen- 
tation later  sought  for  its  own  sake.  Reason  why  these 
pleasures  are  classed  as  holophilic  and  not  as  self-pre- 
servative in  their  latest  manifest  connecti<m  with  the  holo- 
philic Similarities  between  thumb-sucking  and  adult 
sexuality.  In  infancy  all  erogenous  zones  equal  in  pleas- 
ure sensibility  and  independent  of  each  other.  The  par- 
tM  impulaea:  sadism-masochismy  exhibitionism,  impulse 
to  tondi  and  be  touched.  "Polymorphous-perverse'^  and 
autoerotic  nature  of  infantile  sexualitv.  Allerotic  phe- 
nomena in  infancy  differing  from  adult  in  lack  of  syn- 
thesis of  the  erogenous  zones  and  the  partial  impulses 
under  the  primacy  of  the  genital.  In  adults  the  re- 
lation of  partial  impulses  to  the  erogenous  zones  that  of 
fore-pleasure  to  end-pleasure,  while  in  infancy  all  holo- 
philic pleasures  are  end-pleasures.  Inhibitions  in  period 
of  childhood:  shame,  modesty,  disgust,  etc.  Ameliora- 
tion of  the  (Edipus  complex.  The  latency  period  and  the 
normal  interruption  of  it  at  puberty.  The  building  up 
of  the  hierarchv  under  the  primacy  of  the  genital  sys- 
tem. Morbid  disturbances  possible  at  every  step  in  this 
development.  Infantile  sexual  theories  and  their  sig^ 
nificuice  in  determining  psychoneurotic  symptoms  m 
adult  life.    Ijiter  amnesui. 


•  • 


CONTENTS 


CHAPTER  II 
Ths  UKooKSGions 30 

The  concept  of  canae  and  effect  valid  in  the  psychical  as 
well  as  in  the  physical  realm.  Objections  answered. 
Ulustrations  from  hypnosis,  abnormal  psychologr,  prej- 
udices and  religious  beliefs.  Rationalimtion  blinds  us  to 
the  validtiy  of  the  causal  principle  in  psycholo^rsr.  The 
Foreconscious  and  the  Unconscious  distinguish^;  ideas 
in  the  Foreconscious  accessible;  those  in  the  Uncon- 
scious inaccessible  to  consciousness  except  by  analytical 
inference.  Repression  the  cause  of  this  inaccessibility; 
repression  and  activation.  Activation  and  counter- 
activation,  the  former  mediated  by  pain,  the  latter  by 
society.  Origin  of  repression  in  infancy.  The  first  re- 
pression; the  Narcissistic  period;  the  period  of  the  ego- 
ideal.  The  Ego-ideal  as  an  assimilation  of  the  social 
environment.  Conscience  as  a  re-extemalisation  of  the 
father  imago,  and  contains  more  than  specific  morality. 
The  E^ideal  a  structure  of  the  foreconscious  and  not 
consciously  formulated.  The  Censor  as  an  effect  of 
trends  in  the  foreconscious.  The  Unconscious  present  in 
the  psychic  apparatus  from  the  beginning  both  of  the 
race  and  of  the  individual,  and  has  no  regard  for  reality 
or  for  time.  Difference  between  the  blind,  instinctive 
urge  and  its  visible  manifestations.  The  former  as  real 
as  the  latter.  Instinct  as  a  creator  of  tensions  inhibited 
in  the  foreconscious,  which  is  the  seat  of  counter-activa- 
tions. The  foreconscious  likened  to  a  screen  not  so  good 
a  metaphor  as  being  likened  to  a  theatrical  manager,  who 
impresses  certain  attributes  upon  the  unconscious  ma- 
terial. Instability  of  the  control  of  the  foreconscious. 
Hie  drug-taking  compulsion.  Its  oriffhi  in  an  infantile 
sexual  theory.  The  descendants  of  tiie  repressed.  The 
second  or  superficial  censor. 


CHAPTER  III 

Two  Kinds  of  Thineinq,  and  the  Psyohologt  of 

Dbeam 89 


Thinking  according  to  the  Reality  Principle  and  that 
according  to  the  principle  of  Pain  and  Pleasure.  The 
former  done  mostly  in  words,  is  fatiguing,  is  directed  by 
a  goal  idea,  the  latter  in  images  and  not  so  directed  and 
does  not  fatigue.  The  two  types  correspond  roughly  to 
the  two  psychic  systems.  Pleasure  Thinking  to  the  uncon- 
scious, Reality  Thinking  to  the  conscious  system.  Suck- 
ling iskfant  realizes  satisfaction  by  the  hallucioatory  route. 


•  •• 


CONTENTS 

VAQB 

Gtrw  plaee  to  Beality  Thinking  in  adult  life,  but  not 
eomplately.  Day  dreuns  and  n^ht  dreams  a  residue  of 
Pleasure  Thinking  in  adult  life.  The  dream  the  'imag- 
inary fulfillment  of  a  wish."  Falsity  of  this  statement 
only  apparent.  The  dream  interpretable  somewhat  as  a 
rebus,  allegory  or  cartoon.  Dream  of  Palmer's  perfume. 
Roman  soldier  cartoon.  Symbols  in  dream  and  in  car- 
toon, the  latter  labelled,  the  former  not.  Dream  of 
Springfield,  Mass.;  of  the  peri-anus.  Manifest  and  latent 
eontent  of  dreams.  In  night  dreams  the  wish  disguised. 
Dream  of  shop  window,  and  interpretation.  The  dream 
processes:  1.  Condensation,  2.  Displacement,  3.  Drama- 
tization. Topical  symbolism  in  dreams.  4.  Secondary 
Elaboration.  The  dream  a  preseryer,  not  a  disturber,  <d 
sleep  (except  nijghtmares).  Significance  of  the  dream 
for  pqrehouialysis.    Symptom  uid  dream. 

CHAPTER  IV 

ThB   MbCHAKIBMS   of   PSTCHOPATHOLOGIGAIi   MaNI- 

FSSBTATIONS 124 

Neurotic  symptoms  have  piychical  mechanisms,  the 
same  as  those  in  dreams.  The  cause  of  a  young  woman's 
forgetting  the  name  '^Milton."  Overoompenaation.  Com- 
pensatory hypertrophy  and  its  analogue  in  the  psychie 
sphere — overcompensation.  The  neurotic  girl's  constant 
alarm  concerning  her  mother.  Married  woman's  extrava- 
gant solicitude  for  her  children.  Interest  in  Christian 
Science.  Overcompensation  in  a  militant  feminist  and 
wliat  it  covered.  Most  radical  movements  have  neurotica 
as  conspicuous  supporters.  Antivivisectionism,  Southern 
chivaliy  and  lynching  as  overcompensations  for  sadistic 
trends.  Diaplaeefnent.  SuUimation  one  of  its  forms. 
Sublimation  of  a  sadistic  trend  in  the  study  of  chem- 
istry. Displaconents  of  the  drug-taking  young  woman; 
of  uie  man  catching  trains;  the  young  man  vmo  breaks 
rules.  Origin  of  klentomania.  Displacement  in  young 
man  needing  a  studio  away  from  his  home.  Diffuse 
displacement  Projection  ordinarily  a  defense  mechan- 
ism,  e.g.,  in  the  widow  who  moved  away  from  a  sub- 
urb to  New  York.  A  girl's  projection  of  her  guilty 
fedings  into  an  attack  on  the  pnysician.  The  projection 
of  a  reproadi.  A  girl's  projection  of  her  desires  on  to 
the  teadiers  with  vmom  sne  studied.  A  man's  projection 
of  self-reproach  for  impotence,  into  accusing  his  wife 
of  infidelity.  Morbid  jealousy  in  women  and  in  men. 
introfeotion.  The  reverse  of  projection  and  also  called 
« Identtfication,  of  which  there  are  two  kinds,  subjeetlva 
and  dijective.  Nonnal  identification.  Case  of  a  woman 
identifying  herself  with  Evelvn  Nesbit  Thaw;  of  a  phy- 
sician who  Identified  himself  with  a  murderer;  of  a 


CONTENTS 

FAOB 

Sitient  tHio  identified  himself  with  a  patient  of  Dr. 
rill's.  BaHonaUeatUm.  Neurotics  rather  more  intel- 
ligent than  the  average.  Few  even  normal  people  really 
know  the  causes  of  their  actions.  Patient  who  declared 
he  would  many  a  rich  girl  gives  wrong  reason  for 
marrying  a  poor  ^rl.  Rationalization  in  another  pa- 
tient's ammiente  m  favor  of  woman  suffrage,  of  elec- 
tion of  Wilson,  against  Wilson's  election.  A  married 
woman  rationalizes  her  wearing  of  black  clothes.  De- 
fence and  Distortion  Mechanisma.  Patient  with  un- 
conscious wish  for  mother's  death  distorted  to  re- 
morse at  death  of  another.  Patient  who  dissuaded  his 
prospects  from  buying  advertising  space,  on  account  of 
not  giving  full  return  for  value  received.  Patient  who 
would  not  bathe  in  cold  water  on  account  of  "small- 
penis  complex."  Washing  compulsions;  reliffious  and 
charitable  work.  The  physician  who  blames  the  patient 
for  lack  of  understanding.  Transference  or  objective- 
identification.  Examples.  The  ''conditioned  reflex"  and 
the  "sensory  pattern.''  Reaction  patterns  formed  before 
the  end  of  sixth  year,  e.  g.,  the  (Eaipus  and  Electra  com- 
plexes. Freud's  "Interpretation  of  Dreams"  quoted. 
Warning  against  misunderstanding  Freud's  statements. 
The  "Imago,"  not  necessarily  an  accurate  picture.  Pa- 
tient transfers  to  physician  feelings  she  has  had  for 
father.  Resemblance  of  this  process  to  psychical  proc- 
esses of  certain  primitive  races.  Case  of  young  man 
infatuated  with  divorcee  older  than  he,  to  whom  he  had 
transferred  his  mother  imago.  Reactions  from  father 
complex;  and  from  mother  complex  in  man  who  could 
have  intercourse  only  with  servants.  Transference  to 
physician  occurs  in  every  analysis,  both  positive  and 
negative;  and  is  uncovered,  but  not  created  by  it. 

CHAPTER  V 
"   The  Nextbosis  as  a  Whous 220 

Neurosis  at  time  of  its  appearance  seems  something 
unprecedented  in  the  individual,  but  is  really  not  dis- 
continuous with  patient's  former  life.  Continuity  every- 
where complete.  Neurosis  conditioned  by  a  failure  of 
repression,  which  is,  however,  never  complete.  Neurotic 
symptoms,  like  dreams,  are  manifestations  of  the  Uncon- 
scious, which  can  only  wish.  Each  symptom  an  at- 
tempted realization  of  one  or  more  unconscious  wishes, 
chiefly  sexual  or  holophilic.  Question  why  this  is  so  not 
relevant.  Sexual  factor,  present  in  all  reported  cases, 
even  when  not  seen  or  admitted  by  the  writers.  Physi- 
cian with  unsolved  complexes  unable  to  remove  his  own 
and  patients'  resistances  against  sex  confessions.  Neu- 
rosis the  negative  of  the  sexual  perversion;  both  repre- 


CONTENTS 


Bcntlpg  a  partial  arrest  of  development.  Fixation  and 
inhibition  of  inetincts  by  habit.  Fixation  of  holophilic 
impnlee  not  merely  upon  an  object  but  upon  an  aim  or 
type  of  action.  Holophilic  impulses  not  specific  in  aim, 
a  condition  which  alone  renders  sublimation  possible. 
Libido  fixed  on  type  of  action  becomes  specific  Second 
object  selection  occurring  after  puberty  influenced  in 
normals  by  the  unconscious  portion  of  the  libido,  and 
dominated  in  neurotics.  The  love  specifications  of  the 
neurotic  more  numerous.  Early  fixed  libido  can  only 
exceptionallv  be  satii^ed  in  reality  and  wishes  must 
remain  in  the  Unconscious.  Fundamental  difference  be- 
tween neurotic  and  normal  person  is  that  neurotic  has 
kamed  to  love  and  hate  too  soon.  Fixation  points  are 
weak  points  in  the  holophilic  synthesis.  R^ression  of 
libido  to  earlier  lines  of  discharge  paralleled  by  a  r^^res- 
sion  to  more  internal  paths  of  imagination^  producing 
Introversion.  Masturbation  and  phantasies  later  giving 
way  to  a  real  sexual  object,  a  process  reversed  in  neuro- 
sis. Regression  a  preliminary  to  neurofli«.  The  neu- 
rotic uses  his  illness  as  a  means  to  attain  various  ends. 
The  neurosis  a  defense  against  the  pain  of  non-realiza- 
tion of  narcissistic  wishes.  Neurotics  neither  Immoral 
nor  unmoraL  Immediate  cause  of  outbreak  of  neurosis 
is  deprivation  of  some  love  gratification;  sexual  absti- 
nence. Freud  quoted.  Morbid  fear  or  anxiety  a  result 
ol  damming  up  of  libido.  Difference  between  morbid  and 
normal  fear  is  that  former  is  a  relatively  excessive  one, 
and  is  a  difference  of  origin.  Kormal  fear  originates 
from  external  world,  morbid  from  the  Unconscious. 
Nature  of  emotion — a  deed  yet  retained  within  the  or* 
ganism.  Sexual  emotion  physiologically  like  any  other, 
but  psychically^  less  dependent  on  external  stimulation 
than  other  kinds.  Anxiety  neurosis  as  described  by 
Freud.  Biological  significance  of  fear.  Source  of  mor- 
bid fear  withm  the  organism  nothii^  novel  as  the  dis- 
tinction between  external  and  internal  is  comparatively 
late  in  ontogenetic  development.  That  which  causes 
pain  is  regarded  as  external.  Morbid  fear  causes  sub- 
ject to  act  toward  a  part  of  himself  as  if  it  were  hostile. 
Morbid  fear  in  one  sense  not  morbid  but  a  normal  re- 
action to  an  abnormal  condition.  Anxiety  neurosis  a 
variety  of  anxiety  hysteria.  Warning  against  talcing 
word  sexual  too  narrowly. 

CHAPTER  VI 

PlSrCHOLOGY  OP  THE  COMPULSION  NSUROSIS  .       .       .    270 

Neurasthenia  a  misnomer.  Phobias  and  panics.  Ex- 
amples of  compulsions  showing  mesalHanoe  between  affect 
and   idea  content,  both   quwtative   and  quantitative. 


CONTENTS 

Source  of  affects  entirely  in  the  UnconaciouB,  and  affects 
are  attached  to  wrooff  ideas.  Necessity  of  admitting  on- 
eonsdouB  p^chic  activities.  Repressed  wishes  just  as 
dynamic  as  the  unrepressed.  Compulsion  in  the  drug- 
takinff  case  shows  wish  entering  consciousness  as  a  wish 
but  madied  to  new  idea.  In  oompultiye  fears  the  wish 
energy  is  transformed  into  anxiety.  Case  of  young  man 
buying  a  straw  hat,  showing  overcompensation.  Role  of 
sadism  in  compulsion  neuroses.  Love  and  hate  for  same 
object.  Weakness  of  will,  in  matters  of  love,  spreading 
to  other  situations.  Compulsions  represent  effort  to 
compensate  for  doubt  in  love  life.  Compulsions  are  sub- 
stitute activities.  Two-sided  compulsive  acts,  opposite 
impulses  being  discharged  separately.  Ambivalence. 
Regression  of  libido  in  compulsion  neurosis  which  is  the 
neoative  of  the  sadistic  perversion.  The  curiosity  im- 
piuBe  causes  morbid  pondering.  Superstition  in  compul- 
sion neurotics  conceniing  the  death  of  others.  Omnipo- 
tence of  wishes.  Difference  between  compulsion  neurosis 
and  hysteria.  Case  of  prostitute  showing  failure  to  see 
connection  between  her  neurosb  and  her  life. 


CHAPTER  Vn 
A  Case  of  Compulsion  Neubosis 308 

Introduction.  Historical.  Results  of  previous  treat- 
ment. Analytic  data.  Father  complas.  Separation 
complex.  Assault  obsession.  Resistance  against  mar- 
riage. Analysis  of  the  assault  obsession.  RAle  of  the 
tuberculosis  complex  in  the  love  choice.  Analysis  of  the 
Kishef  obsession.    Further  details.    Conclusion. 


CHAPTER  Vin 

The  Psychology  of  Anxiety  Hysteria  .    •.     .     .  430 

Most  common  in  women,  the  compulsion  neurosis  in 
men.  Chief  manifestation  of  anxiety  hysteria  is  morbid 
fear.  Phobia  and  panic.  Three  examples.  Ideational 
element.  Story  of  the  fanner  getting  drunk.  Genesis 
of  the  anxiety  through  displacement  of  wish  energy  to 
substitute  idea  of  dangerous  man.  Fears  cannot  be 
reasoned  away.  Revolver  no  protection  against  thirst. 
Morbid  fear  an  expression  of  essentially  feminine  traits 
Anxiety  neurosis  tJie  necative  of  the  masochistic  perver- 
sion. Stella's  fear  of  "dead  souls"  displaced  from  anal- 
erotic  wishes. 


CONTENTS  xxvu 

CHAPTER  IX 
A  Case  of  Anxiety  Htstebia 411 

History.  Fint  seizure,  followed  by  two  others  in 
three  weeks.  Hypnotism  sufflested  but  rejected.  Psy- 
choanalysis accepted.  (1)  The  "spookiness"  of  hypno- 
tism, (2)  The  love  look  of  the  hypnotized  subject,  (3) 
The  expression:  "I'm  crazy  about  him!"  (4)  The  read- 
ing of  newspaper  reports  about  white  slavery,  (6)  The 
talk  with  the  j^rl  fnend,  (6)  The  fear  of  infection  and, 
(7)  The  association  of  it  with  hair  on  the  back  of  Mr. 
D/s  hands.  Relevance  of  these  seven  thouffhts  all  point- 
ing to  fear  of  sex.  Dream  of  being  chased  oy  a  Japanese 
girL  Dream  of  being  bitten  by  a  dog.  Its  interpreta- 
tion  withheld.  Aesociations:  Talk  with  girl  friend 
about  prostitution,  disease  and  abduction.  Phantasies 
about  first  coitus  show  sado-masochistic  conception  of 
sexuality.  Indentification  of  the  dog  in  the  dream  as 
Mr.  D.  The  dream  contradicts  Miss  6/s  remarks  about 
disliking  Mr.  D.  Her  fears  of  going  to  the  office  now 
explained  as  a  fear  that  she  would  fulfill  her  eexual 
wishes.  Interpretation  of  dream  presented  to  patient, 
the  first  sex  information  imparted,  produces  mcrease 
of  resistance  signifying  a  definite  sexual  experience, 
which  was  then  related  by  patient— an  attempt  at 
masturbation  by  an  older  girl  friend.  Strong  feeling  of 
remorse  in  spite  of  words  of  priest.  Overcompensation. 
More  sex  information  imparted.  Resistance  at  time  of 
explanation  of  dog  dream  due  to  the  homosexual  experi- 
ence. Resentment  against  her  parents  for  not  warning 
her  of  possible  sexuM  advance  of  girls.  Protestations  <S 
ignorance.  "Ber  learning  about  coitus  at  the  age  of  thir- 
teen. Her  enuresis  from  five  to  six.  The  consequent 
oonnection  of  intercourse  with  dirtiness.  New  resist- 
ances. The  flower  incident.  Fear  to  make  the  next  visit. 
Phantasy  of  the  girl  who  eloped  with  a  doctor.  Trans- 
ference phenomena.  Belittling  the  psychoanalyst  caused 
bv  the  transference.  The  feeflngs  tnus  discovered  really 
directed  in  the  unconscious  toward  some  one  else  now 
represented  by  the  psychoanalyst.  Patient  admits  the 
feeling  for  Mr.  D.  once  experienced  when  he  touched  her 
arm.  Episode  of  Dr.  Y.  Interruption  of  the  analysis. 
The  affair  with  Dr.  Y.  a  compromise.  Dream  of  riding 
on  a  subway  train.  Its  interpretation  resulting  in  prog- 
ress. Her  continued  dislike  of  Mr.  D.  masking  a  real 
sexual  attraction  toward  him.  Her  ineradicable  feeling 
that  sex  was  sinful.  The  dream  of  going  for  treatment. 
Its  interpretatioii.  Reading  of  '*His  Hour"  as  material 
for  assault  phantasies.  Interpretation  of  the  neurosis. 
1.  Plash  of  sexual  feeling  toward  Mr.  D.  on  subway,  2. 
reading  white  slave  reports,  3,  reading  *His  Hour,"  4,  in- 
cident of  beiJig  chased  by  a  man,  and  5,  her  first  attack  on 


I 

0 


xxviii  CONTENTS 

day  of  expected  visit  to  her  homosexual  friend — all  show 
inclination  for  Mr.  D.  Her  idealized  love  shown  as  an 
infantili^.  Dream  of  flying  bird.  Dream  of  being  in 
wedding  dress.  The  divorce  phantasy.  Its  unreasonable- 
ness not  admitted.  The  displacement-of-disadvantage 
mechanism.  Dream  of  running  away  from  marrying  a 
Chinaman.  The  wealthy  foreigner.  Money  as  a  resist- 
ance against  marrying  Mr.  D.    Conclusion. 

SYNOPSIS  OP  CHAPTER  X 

Thb  Theory  and  Mechanism  of  the  Psycho- 
ANALYTIC  Cure 496 

Historical;  use  of  hypnosis  to  restore  memory  aban- 
doned. Emphasis  removed  from  symptom  to  resistance. 
Neurotic  compared  to  imprisoned  man.  Unhappiness  of 
both  due  to  sense  of  guilt.  Resistance  due  to  conscience^ 
which  is  habit  and  not  instinct.  A  retriever  carries 
birds  as  if  they  were  full  of  pins.  The  neurotic  acts  hi 
accordance  with  an  infantile  pattern.  Psychoanalysis 
lets  the  patient  know  what  he  is  doing.  Filling  of  gaps 
of  memorr  is  the  removing  of  resistance,  and  shows  the 
patient  the  significance  of  his  actions.  The  reformed 
Jew  and  his  reaction  to  ham.  Case  of  male  patient 
losing  affection  for  wife  an  instance  of  habit  or  complex 
formed  by  childhood  experience.  Psychoanalytic  expla- 
nation cured  by  showing  him  what  he  was  doing.  Psy- 
choanalysis diagnostic  and  disintegrative.  The  disinte- 
grations are  accomplished  in  two  ways;  first  by  patient's 
recalling  the  experiences  which  formed  the  complexes  and 
second  by  re-living  them  In  the  form  of  transference. 
Re-living  or  re-enactment  described  in  the  case  of  male 
patient.  While  convention  is  frequently  a  pushing  back 
(repression),  psychoanalysis  is  a  true  re-education  or 
drawing  out  of  the  powers  of  the  individual. 

BiBUOGRAPHY 555 


t       '       • 


MORBID  FEARS  AND 
COMPULSIONS 

CHAPTEE  I 

THE  SEXUAL  SYNTHESIS 

HIPPOCBATES,  the  Father  of  Medicine, 
taught  that  the  malady  known  as 
hysteria  arose  when  the  unsatisfied 
womb,  longing  for  the  seed  of  the  male,  broke  loose 
from  its  fastenings  and  restlessly  wandered  about 
the  ioterior  of  the  body.  In  accordance  with  this 
theory  he  applied  sweet  perfumes  to  the  vulva  of 
the  patient  and  evU-smeUing  substances  to  her 
nostrils,  vnih  the  idea  that  by  such  means  the 
mutinous  organ  might  be  induced  to  return  to  its 
proper  locus.  Benmants  from  this  theory  are 
handed  down  to  present  day  medicine  as  the  name 
we  apply  to  the  disease  (hysteria,  from  wrripaj  the 
womb)  and  the  practice  of  administering  to 
neurotic  patients  certain  ill-smelling  drugs  such  as 
asafoetida  and  valerian. 

Since  the  days  of  Hippocrates  the  theories  ad- 
vanced to  explain  hysteria  and  the  other  psycho- 
neuroses  have  been  both  numerous  and  varied, 
some  of  them  being  no  less  fantastic  than  his.  But 
throughout  there  has  been  noticeable  a  persistent, 


.    2     M0R3ID.  FEARS  AND  COMPULSIONS 

if  ill-definedy  tendency  to  locate  the  cause  of  the 
trouble  in  the  organs  of  generation.  The  constant 
search  for  malpositions  of  the  uterus,  cervical  or 
perineal  lacerations  or  other  pelvic  disturbances 
in  neurotic  women,  and  the  multitude  of  operations 
that  have  been  undertaken  with  the  idea  of  curing 
the  neurosis  by  removing  these  conditions  are  but 
a  few  of  the  manifestations  of  this  tendency. 

It  remained  for  Freud  to  show  that  this  indina- 
!  tion  to  regard  the  reproductive  organs  as  the  site 
of  the  causal  factors  of  the  functional  neuroses 
had,  in  a  way,  its  justification,  and  really  amounted 
to  a  dim,  imperfect  intuition  of  what  actually  is 
the  truth.  We  know  now,  thanks  to  his  genius, 
that  in  these  cases  the  trouble  really  resides  not  in 
the  sexual  organs  of  the  patient  but  in  the  sexual 
instinct. 

The  violent  and  bitter  prejudice  which  arose 
against  this  doctrine  of  Freud's  could  in  large 
measure  be  ascribed  to  the  peculiar  feeling  preva- 
lent among  Caucasian  peoples  that  there  is  some- 
thing inherently  shameful  and  indecent  about  sex, 
in  consequence  of  which  they  are  quick  to  resent 
whatever  implies  directly  or  indirectly  that  the 
erotic  impulses  are  of  much  consequence  to  them. 

Another  important  factor  which  interfered  with 
Freud's  teachings  was  that  people  failed  to  under- 
stand just  what  he  meant  by  the  term  sexual,  an4 
thus  saw  in  his  writings  meanings  that  he  never 
intended,  and  derived  impressions  totally  differ- 
ent from  those  he  wished  to  convey.  These  false 
notions  caused  many  to  reject  his  teachings  who, 
had  they  understood  him,  might  have  investigated 


INFANTILE  SEXUALITY  3 

farther  and  readily  accepted  his  views.  What  in 
many  instances  excited  prejudice  was  really  some- 
thing quite  different  from  what  Freud  had  tried 
to  teach. 

In  view  of  this,  I  think  it  well  to  begin  by  an  at- 
tempt to  make  dear  what  is  meant  by  the  term 
sexual  when  used  in  the  Freudian  sense,  and  what 
we  shall  understand  the  sexual  instinct  to  be. 

Each  individual  leads  a  double  existence ;  on  the 
one  hand  he  is  an  entity  in  himself ,  on  the  other  an 
insignificant  component  of  that  larger  entity,  his 
race  or  species. 

Corresponding  to  these  two  roles  he  has  two 
great  groups  of  impulses  or  instinctive  tendencies, 
the  one  wholly  egoistic  or  self -preservative,  the 
-other  essentially  altruistic  and  preservative  of 
the  race.  Of  the  first  group  hunger  is  the  chief 
sensational  representative,  of  the  second  the  desire 
for  sexual  congress. 

If  one  studies  some  simple  organism,  for  in- 
stance the  amcBba,  it  is  easily  apparent  that  all 
its  processes  fall  readily  into  one  or  the  other  of 
the  two  groups,  self -preservative  and  reproduc- 
tive. If  comparative  studies  are  then  made  with 
other  organisms  higher  in  the  phylogenetic  scale, 
it  will  be  found  that  there  is  nothing,  not  excepting 
even  the  most  complicated  mental  processes  of 
dvilized  man,  that  is  not  represented  in  some  sim- 
ple and  rudimentary  way  in  the  lower  organisms, 
even  to  the  amoeba.  Thus  every  item  of  human 
behavior  whether  it  be'*  explicit*'  (action)  or*  im- 
plicit'' (thought  or  feeling)  ^  is  revealed,  either  to 

1  J.  B.  WatMm,  ''Behavior/'  Henry  Holt  &  Go. 


r 


4  MOBBID  FEABS  AND  COMPULSIONS 

direct  observation  or  by  tracing  it  back  through 
phylogenetic  history,  as  belonging  either  in  the 
self -preservative  or  in  the  race-preservative  group 
of  reactions. 

Now  suppose  we  name  these  two  great  groups 
each  according  to  its  chief  representative.  All 
processes  belonging  to  the  self -preservative  group 
would  then  be  called  hunger  processes,  all  those 
of  the  other  would  be  termed  sexual  processes. 
Thus  our  desire  to  have  warm  clothes  in  winter 
and  cool  ones  in  summer  would  be  called  a  hunger 
phenomenon,  while  a  wish  that  these  clothes  might 
look  well  would  be  considered  to  belong  to  the 
sphere  of  sex.  It  is  exactly  in  this  hroad  and  in- 
clusive sense  that  Freud  uses  the  term  sexual. 
With  him  it  embraces  all  those  reactions  that  are 
race-preservative  in  purpose  or  effect  according 
to  their  phylogenetic  or  ontogenetic  history.  His 
use  of  the  word  would  be  exactly  paralleled  by 
including  all  the  self -preservative  processes  under 
the  term  hunger.  The  word  sexual  in  the  Freud- 
ian sense  is  thus  most  nearly  synonymous  with  the 
Greek  "Epw  (Eros)  or  the  English  word  Love, 
though  having  an  even  broader  meaning  than 
either  of  them.  The  phenomena  popularly  termed 
sexual  represent  only  a  comparatively  small  por- 
tion of  Ihe  group  which  are  sexual  in  Fred's 
sense.^ 

;ilt  may  be  conceded  that  Freud's  selection  of  this  term  to 
denote  the  large  group  of  phenomena  to  which  he  applies  it  was 
not  particularly  happy,  for  apparently  it  has  led  to  much  mis- 
understanding. Also  it  has  been  complained  that  he  stretched 
the  meaning  of  the  word  beyond  all  reason.  The  situation  was, 
of  course,  that  since  there  is  no  term  current  that  expressed  the 


INFANTILE  SEXUALITY  5 

Corresponding  to  the  two  great  groups  of  pro- 
cesses or  reactions  into  which  the  phenomena  of 
the  individual  life  may  be  divided,  there  are  as- 
sumed two  great  groups  of  impulses  or  tendencies, 
the  self -preservative  or  ego-instinct,  and  the  sexual 
or  holophilic  instinct  as  the  source  from  which  each 
group  of  processes  gets  its  primal  push  and  drive. 
For  our  reactions  to  the  stimuli  we  receive  usually 
if  not  invariably  represent  out-puts  of  energy  en- 
tirely out  of  proportion  to  the  amounts  of  energy 
impinging  on  our  sense  organs  as  the  stimuli 
themselves.  If  for  instance  a  photographic  plate 
in  a  camera  is  exposed  to  the  light  rays  coming 
from  a  grizzly  bear,  an  impression  is  made  on  the 
plate  which  is  directly  proportional  to  the  amount 
of  light  and  the  length  of  time  of  exposure.    But 

ezaet  meaning  he  wftnted,  he  had  either  to  invent  a  new  word  or 
elee  broaden  the  meaning  of  the  one  already  in  use.  That  he 
chose  the  latter  course  instead  of  the  former  would  have  been  all 
right,  could  people  have  been  made  to  understand,  as  they  did 
not,  that  it  was  in  this  new  and  broad  sense  that  the  word  was 
generaUy  used.  As  a  matter  of  fact,  in  a  good  deal  of  psycho- 
analytic writing  the  word  sexual  is  used  now  in  the  broad  sense 
and  now  in  the  narrow  sense,  without  the  authors'  always  taking 
the  trouble  to  state  in  which  sense  it  is  to  be  construed.  It  has 
occurred  to  me  that  the  word  holophilic,  from  dXot,  whole,  and 
^iX^,  love,  thus  meaning  aU  kinds  of  sexual  or  love  phenomena, 
mi^t  be  a  convenient  synonym  for  the  word  sexual  in  Freud's 
sense,  and  that  its  judicious  use  would  serve  to  avoid  some  pos^ 
siUe  misunderstanding.  I  do  not  wish  to  replace  the  word  secf- 
wU  entirely,  for  that,  too,  might  lead  to  misunderstanding.  In 
this  bode,  therefore,  I  propose  to  use  the  two  words  interchange- 
ably and  as  synonymous  with  one  another,  hoping  by  so  doing 
to  emphasise  the  broad  way  in  which  the  word  sexual  should  be 
construed  without  tiring  the  reader  with  repeated  statements 
about  it.  I  shall  attempt  particularly  to  use  the  word  holophilic 
in  such  connections  where  the  word  sexual  would  be  most  apt 
to  be  erroneously  taken  in  its  narrow  sense. 


6  MORBID  FEABS  AND  COMPULSIONS 

if  these  same  rays  impinge  on  another  sort  of  sen- 
sitized plate,  the  retina  of  a  human  being  or  of  an 
animal,  there  results  an  effect  in  the  shape  of  fear 
and  flight,  the  energy  output  of  which  bears  no  def- 
inite ratio  to  the  energy-content  of  the  incoming 
rays,  and  is  of  infinitely  greater  magnitude.  The 
role  of  the  stimulus  in  this  and  practically  all  other 
cases  is  that  of  releasing  into  kinetic  expression 
energy  that  is  latent  within  the  organisuL  To 
express  this  notion  of  latent  energy  we  require  the 
term  instinct  which  we  conceive  to  be  the  source 
of  the  energy  which  is  released  as  the  responses  to 
various  external  or  internal  stimuli.  To  the  en- 
ergy itself  which  is  thus  released  we  g^ve  in  the 
case  of  the  holophilic  group  of  phenomena  the 
name  Libido.^ 

Just  as  everything  in  the  lives  of  the  higher  or- 
ganisms can  be  found  represented  in  some  simple 
or  rudimentary  way  in  the  lives  of  the  lower,  so 
practically  everything  in  the  adult  has  some  sort 
of  representation  in  the  child.  However  trite  this 
statement  may  appear,  its  application  in  the  psy- 
chosexual  sphere  was  hardly  recognized  at  all  until 
the  work  of  Freud.  The  sexual  instinct  was  pop- 
ularly supposed  to  appear  at  the  time  of  puberty; 
the  child  was  tacitly  assumed  to  be  practically 
asexual  before  that  period.    Whether  the  instinct 

iLike  the  word  sexual  the  woTd  libido  must  be  coiutnied  in 
peychoanalTtic  writing  in  a  broad  sense  while  popularly  it  is 
used  in  a  narrow  one,  and  hence  the  same  objections  apply  to  it 
that  arise  against  the  formet.  For  this  reason  Jung  has  sug- 
gested that  it  be  replaced  by  the  Greek  6pft^  (Horm4).  "On  Psy- 
thological  Understanding,"  Journal  of  Abnormal  Psychology,  Vol. 
IX,  No.  6. 


INFANTILE  SEXUALITY  7 

has  any  prepubertal  representation  or  in  what  this 
representation  ought  consist  hardly  anybody 
stopped  to  enqnire.  One  of  Freud's  great 
adiievements  was  the  demonstration  that  the  sex- 
ual instinet  as  first  manifested  at  the  time  of  pu- 
berty is  not  new  but  so  to  speak  a  synthetic  prod- 
uct, formed  by  uniting  certain  of  a  number  of  holo- 
philic  trends  or  impulses  which  were  present 
throughout  childhood  and  thus  that  the  germs  of 
sexnality  are  present  in  the  individual  from  his 
verybirtlL 

!niat  this  discovery  of  Freud's  should  have 
given  rise  to  astonishment  and  incredulity  is  from 
one  point  of  view  very  surprising.  All  tiie  recep- 
tor surfaces,  all  the  complicated  systems  of  volun- 
tary, sympathetic  and  autonomic  arcs  and  end-or- 
gans involved  in  the  reactions  represented  by  the 
love  life  of  the  adult  are  present  in  practically 
their  fully  developed  form  long  before  the  begin- 
ning of  puberty.  Apparently  the  change  which 
takes  place  at  puberty  results  not  from  new  arcs 
being  introduced  or  in  old  ones  suddenly  becom- 
ing permeable,  but  rather  in  the  maturing  of  cer- 
tain glands  which  now  begin  to  pour  their  inter- 
nal secretions  into  the  blood  stream  and,  in  the 
male,  furnish  a  new  substance  for  external  dis- 
charge. It  would  be  hard  to  believe  aU  this  com- 
plicated machinery  waited  silent  and  idle,  or  was 
responsive  only  to  non-sexual  stimuli  and  capable 
only  of  non-sexual  reaction's  during  all  the  years 
preceding  puberty  and  this  glandular  activity. 
On  the  contrary  it  would  be  logical  to  expect  the 
occurrence  of  many  and  complicated  reactions, 


8    MORBID  FEAES  AND  COMPULSIONS 

lackmg  to  be  sure  something  possessed  by  the 
sexual  processes  of  the  adult,  but  nevertheless 
fully  deserving  to  be  called  sexual.  This  doctrine 
that  adult  sexuality  develops  by  a  sort  of  synthe- 
sis out  of  a  preexisting  sexuality  we  should  have 
been  prepared  for  by  expecting  that  the  effect  of 
the  internal  secretions  appearing  at  puberty 
would  be  merely  that  of  adding  further  power 
and  emphasis  to  certain  reactions  of  the  compli- 
cated machinery  already  present  and  freely  re- 
acting before  the  attainment  of  sexual  maturity. 
We  should  have  known  that  the  psychosexual 
phenomena  of  the  adult  could  not  have  developed 
de  novo  at  puberty,  but  could  only  represent  what 
had  been  present  much  earlier,  now  brought  into 
high  relief  through  the  added  effect  of  the  new 
secretions. 

In  the  sexuality  of  the  human  being  three  phases 
or  periods  of  development  may  be  distinguished : 

(1)  an  infantile  or  pre-inhibitory  period  which 
corresponds  to  the  first  three  or  four  years  of  life ; 

(2)  the  childhood  or  latency  period  which  succeeds 
the  first  and  ends  with  the  onset  of  puberty,  and 

(3)  the  adult  period,  or  phase  of  object-love. 
The  first  period  may  be  called  the  pre-inhibitory 

period  because  it  represents  a  stage  in  which 
the  so-called  reaction-tendencies,  (the  inhibitory 
trends  such  as  shame,  disgust,  modesty,  sympathy, 
etc.)  are  not  yet  manifest.  The  child,  during  this  ' 
first  period,  is  incapable  of  any  of  these  feelings ; 
as  soon  as  he  becomes  capable  of  them  the  period 
comes  to  a  dose  and  the  latency  period  has  its  be- 
ginning. 


INFANTILE  SEXUALITY  9 

The  holophilic  phenomena  of  the  first  period 
consist  chiefly  in  the  pleasurable  sensations  which 
the  infant  derives  from  the  stimulation  of  certain 
sensitive  areas  which  are  known  as  the  erogenous 
zones.  These  zones  are  represented  by  the  anal, 
oral,  and  urethral  orifices,  the  penis  in  the  male 
and  the  labia  and  clitoris  in  the  female.  The  first 
pleasurable  stimulations  from  them  are  incidental 
to  the  performing  of  the  functions  of  alimentation. 
In  the  infant  the  pleasure  derived  from  the  taking 
of  nourishment  is  not  represented  entirely  by  taste 
pleasures  and  the  actual  satisfaction  of  the  craving 
for  food;  the  tactile  and  kinesthetic  sensations 
created  during  the  act  of  sucking  are  distinctly 
agreeable  and  pleasurable  in  themselves.  In  the 
same  way  the  voiding  of  excrement  not  only  repre- 
sents something  more  than  simply  the  relief  from 
the  discomfort  of  not  voiding,  but  also  gives  rise  to 
tactile  and  muscular  sensations  that  have  a  definite 
pleasure  value  in  themselves. 

Having  experienced  these  pleasurable  sensa- 
tions as  incidents  to  the  performing  of  the  alimen- 
tary functions,  the  infant  soon  seeks  to  re-expe- 
rience them  for  their  own  sake.  Thus,  for  in- 
stance, he  develops  the  habit  of  sucking  his  thumb 
or  some  other  available  object,  purely  for  the  sen- 
sory pleasure  the  act  of  sucking  affords  and  quite 
apart  from  any  desire  for  nourishment.  In  the 
same  way  other  children  refuse  to  empty  the  bowel 
when  placed  upon  the  toilet,  and  hold  back  the  feces 
until  there  is  an  accumulation  of  sufficient  size  and 
consistency  to  give  the  act  of  evacuation  the  great- 
est possible  amount  of  pleasure. 


10    MOBBID  FEABS  AND  COMPULSIONS 

It  may  be  asked  why  such  tricks  of  the  infant  as 
thumb-sucking  and  the  holding  back  of  the  feces 
are  classed  in  the  sexual  or  holophilio  group,  and 
not  as  hunger  phenomena.  We  may  answer  that 
the  principal  reason  for  so  regarding  them  is  be- 
cause of  their  later  history.  By  the  study  of  the 
oral  perversions  or  perversities  {fellatio,  cwnm- 
lingua,  etc.,)  the  perverse  action  can  be  demon- 
strated as  a  direct  descendant  of  the  infantile 
pleasure-sucking  which  in  most  cases  of  such  per- 
version had  been  indulged  in  with  great  fervor  and 
continued  for  a  long  time.  Then  too  the  analysis 
of  certain  neurotic  disturbances  such  as  hysterical 
vomiting  and  some  food  idiosyncrasies  reveals 
them  as  a  reaction  against  similar  oral- 
erotic  longings  and  phantasies,  now  offensive 
to  the  controlling  trends  of  the  personality, 
but  likewise  easily  traceable  through  the  de- 
velopmental history  of  the  individual  back  to 
the  pleasure-sucking  of  infancy.  The  oral  erot- 
ism of  the  infant  is  represented  in  the  normal  adult 
as  the  pleasure  in  kissing.  Of  course  the  rudi- 
mentary sexual  activities  cannot  be  expected  to  be 
in  every  particular  like  those  of  the  adult.  Kiss- 
ing in  the  adult  excites  the  genital  system  while 
the  sensations  excited  in  pleasure^sucking  remain 
local.  But  we  must  remember  that  the  intercom- 
munication of  the  various  holophiUc  impulses  (the 
sexual  synthesis)  has  not  yet  been  established,  for 
the  reason  that  the  glands  whose  internal  secre- 
tions are  largely  instrumental  in  its  accomplish- 
ment have  yet  to  mature.  Nevertheless  the  infan- 
tile erotism  as  exemplified  in  pleasure-sucking  ia 


INFANTILE  SBXUALITT  U 

not  set  off  so  sharply  from  adult  sexaality  as  one 
might  perhaps  expect.  In  certain  cases  at  least,  it 
proceeds  to  an  orgastic  climax  succeeded  by  a  pe- 
riod of  complete  passivity  and  relaxation,  the 
whole  phenomenon  bearing  such  a  striking  similar- 
ity to  the  sexual  acme  and  immediately  subsequent 
relaxation  in  the  adult  that  it  could  hardly  escape 
the  observer. 

The  first  stimulations  of  the  penile  and  clitoris 
zones  appear  to  result  either  from  irritations  pro- 
duced by  discharged  secretions  or  excretions  in 
contact  with  them,  or  from  the  manipulations  in- 
volved in  keeping  the  child  clean.  These  pleas- 
urably  experienced  stimulations  the  infant  then 
seeks  to  repeat  either  by  thigh  rubbing  or  the  use 
of  the  hand.  The  former  appears  to  be  more  com- 
mon in  female  infants,  the  latter  in  males. 

All  the  erogenous  zones  in  infancy  have,  at  least 
to  start  with,  about  the  same  degree  of  pleasure- 
sensibility.  As  time  goes  on  the  significance  of 
one  zone  may  be  accentuated  over  that  of  the 
others  through  repeated  stimulation,  but  there  is 
nothing  corresponding  to  the  primacy  that  in  the 
normal  adult  the  genitals  have  over  all  other  re- 
gions of  the  body.  Furthermore,  the  zones  or- 
dinarily remain  perfectly  independent  of  one  an- 
other;  excitement  of  one  does  not  of  itself  produce 
an  excitement  or  heightened  sensibility  in  any  of 
the  others,  as  happens  in  the  adult  when  for  in- 
stance the  oral  zone  is  stimulated  and  the  phenom- 
ena of  sexual  excitement  occur  in  the  genitals 
without  their  being  stimulated  directly. 

In  addition  to  the  zonal  components  of  the  holo- 


12    MORBID  FEARS  AND  COMPULSIONS 

philic  instinct  th^re  appear  a  little  later  a  set  of 
impulses  which  have  at  first  no  connection  with  the 
erogenous  areas.  These  so-called  partial  impulses 
(Partial-triehe)  go  in  pairs  of  which  the  one  is  ac- 
tive and  the  other  passive.  One  of  these  pairs  con- 
sists of  the  sadistic  and  masochistic  impulse.  The 
former  is  an  aggressive  tendency,  and  is  mani- 
fested as  a  desire  to  dominate,  to  use  force,  rough- 
ness or  violence,  and  if  it  goes  far  enough,  to  in- 
flict pain.  ^  The  masochistic  tendency  has  just  the 
opposite  nature,  and  is  shown  as  a  pleasure  in  obe- 
dience, submission,  and  the  enduring  of  humilia- 
tion or  pain. 

A  second  pair  consists  of  the  impulse  to  show- 
ing and  looking,  the  former  passive  and  the  latter 
active.  They  refer  not  only  to  the  genitals  them- 
selves, but  to  the  entire  body.  Out  of  a  union  of 
the  looking  impulse  with  a  contribution  from  the 
acquisitive  trend  of  the  self -preservative  group 
there  develops  the  curiosity  impulse,  of  which  we 
shall  have  a  good  deal  to  say  in  some  of  the  later 
portions  of  this  book.  The  impulses  to  touch  and 
to  be  touched,  etc.,  belong  in  the  same  group  of 
partial  desires. 

These  partial  desires  of  infancy  are  readily 
identified  as  fore-runners  of  tendencies  apparent 
in  the  sex-life  of  the  normal  adult.  The  sadistic 
impulse,  for  instance,  corresponds  to  the  normal 
aggressiveness  in  courtship  shown  by  the  male  in 
comparison  with  the  female,  and  his  inclination  to 

iThe  wish  to  cause  pain  is  not  primary  in  tlie  sadistic  im- 
pulse, though  early  becoming  associated  with  it.  See  Freud's 
<Triebe  und  Triebschicksale/'  Int.  ZeitMohrift  fUr  A.  P.,  1916. 


INFANTILE  SEXUALITY  13 

master,  and  occasionally  to  be  rough  with  the 
loved  object.  This  inclination  corresponds  to  an 
evolutionary  period  when  the  male  had  need  of 
other  means  of  overcoming  the  resistance  of  the  fe- 
male than  those  implied  by  the  term  courtship, 
(marriage  by  capture,  etc.) 

The  disposition  of  the  looking  and  showing  im- 
pulses in  adult  life  is  well  illustrated  by  the  differ- 
ences in  the  evening  dress  of  the  male  and  the 
female.  As  shown  by  this  the  female  has  a 
greater  desire  to  be  looked  at  than  has  the  male, 
while  in  the  male  the  pleasure  in  looking  and  the 
curiosity  impulse  (sexual  curiosity)  is  stronger 
than  in  the  female. 

It  must  be  pointed  out  that  the  partial  impulses 
represent  rudiments  corresponding  not  only  to 
tendencies  normally  present  in  adult  life,  but  also 
to  those  of  certahi  perversions,  sadism,  maso- 
chism, exhibitionism,  etc.  In  fact  there  is  a  per- 
version corresponding  to  each  one  of  the  partial 
impulses  of  infancy.  The  same  may  be  said  with 
regard  to  the  zonal  components.  In  other  words 
the  perversions  represent  great  exaggerations  or 
over-developments  of  some  one  or  other  of  the 
holophilic  tendencies  which  are  normally  present 
in  every  child.  This  has  led  Freud  to  designate 
the  infantile  sexuality  as  ''polymorphous  per- 
verse." This  is  perhaps  an  unfortunate  term  for 
while  it  is  true  that  the  infant  evinces  holophilic 
pleasure  in  all  these  diverse  ways  there  is  nothing 
abnormal  about  it  at  that  stage  of  development. 
The  true  perverseness  results  only  when  those 
trends   experience   a  disproportionate  develop- 


14    MOEBID  FEARS  AND  COMPULSIONS 

ment  and  fail  to  become  subordinate  to  the  genital 
zone  at  the  time  of  the  sexual  synthesis  of  puberty. 

The  conspicuous  feature  of  the  sexuality  of  the 
infantile  period  (and  for  that  matter  of  the  child- 
hood period  also)  is  that  it  is  predominantly  auto- 
erotic.  By  this  is  meant  that  the  child  for  the 
most  part  gains  his  satisfaction  from  his  own 
body;  he  is  not  dependent  as  is  the  adult,  upon  a 
second  person  for  the  satisfaction  of  holophilic 
needs.  In  the  normal  adult  love  life  the  sexual 
object  (this  second  person)  is  indispensable;  the 
sexuality  of  the  infant  is  for  the  most  part  ob- 
jectless. 

Yet  the  predominance  of  autoerotism  in  child- 
hood is  not  absolute.  Often  as  early  as  the  begin- 
ning of  the  second  year  one  can  see  signs  of  the 
rudimentary  object-love  which  foreshadows,  and 
in  a  sense  is  the  model  for,  that  great  factor  in 
adult  life.  Before  the  end  of  the  infantile  period 
these  indications  are  very  clear  and  ordinarily 
bear  the  stamp  of  the  normal  heterosexual  selec- 
tion. The  first  extra-egoistic  holophilic  interests 
developed  by  the  infant  have  as  their  objects  the 
persons  of  the  immediate  environment,  parents, 
nurses,  etc.,  but  the  libido  is  distributed  in  unequal 
quantities  to  these  individuals  so  that  there  is  soon 
revealed  (in  normal  children)  a  preference  for  the 
opposite  sex.  Thus  the  little  boy  loves  the  mother 
more  than  he  does  the  father,  while  with  the  little 
girl  it  is  the  father  who  has  the  preference.  Quite 
generally  the  parent  of  the  same  sex  as  the  child 
is  looked  upon  as  an  interferer  and  rival  for  the 
affections  of  the  parent  more  greatly  loved.    The 


INFANTILE  SEXUALITY  15 

little  boy,  for  instance,  wishes  that  his  father  were 
oat  of  the  way  so  that  he  could  have  his  mother  all 
to  himself.  ^  This  early  object-selection  forms 
the  foundation  of  those  important  constellations, 
the  (Edipus  Complex  (in  the  male)  and  the  Electra 
Complex  (in  the  female)  which  are  of  great  signifi- 
cance not  only  in  the  later  life  of  the  neurotic  but 
in  normal  people  as  well. 

In  these  allerotic  phenomena,  as  distinguished 
from  the  essentially  autoerotic  processes  which 
constitute  the  major  portion  of  the  infantile  holo- 
philic  reactions,  the  nearest  approach  is  made  to 
the  phenomena  of  love  in  the  adult.  The  essen- 
tial difference  is  the  lack  of  synthesis  of  the  va- 
rious impulses  into  any  definite  pattern  or  hier- 
archy such  as  exists  in  normal  adult  life.  That 
is  to  say,  all  the  impulses  remain  as  separate  and 
independent  sources  of  pleasure;  the  significance 
of  the  genital  zone  is  not,  as  in  the  normal 
adult,  accentuated  over  that  of  all  the  others,  and 
the  partial  impulses  are  not  intimately  connected 
with  it.  For  instance,  in  the  adult  the  gratifica- 
tion of  one  of  the  partial  impulses,  for  example  the 
desire  to  touch  the  loved  object,  though  giving 
pleasure  at  the  same  time  creates  a  desire  for  a 
greater  pleasure,  that  of  coitus.  Thus  the  two 
stand  to  each  other  in  the  relation  of  fore-pleasure 
and  end-pleasure.    In  infancy  there  is  no  differen- 

1  That  this  desire  frequently  takes  the  form  of  a  wish  that  the 
father  were  dead  need  canee  no  astonishment,  for  at  this  period 
the  idea  of  death  means  nothing  more  to  the  child  than  simply 
"gone  away/'  and  eiLcites  none  of  the  horror  that  it  has  for  the 
adult 


16    MORBID  FEAES  AND  COMPULSIONS 

tiation  into  pleasures  of  different  order.  All  the 
holophilio  pleasures  are  end-pleasures,  and  what 
organization  exists  among  the  various  impulses  is 
a  pregenital  organization.  The  sexual  pleasures 
of  this  period  are  for  the  most  part  lacking  in  the 
genital  component,  unless  the  genitals  are  directly 
stimulated. 

It  must  not  he  understood  from  what  I  have  said 
ahout  the  CBdipus  complex  and  the  heterosexual 
predominance  in  the  infantile  object-love  that  all 
the  child's  holophilic  interest  or  libido  is  distrib- 
uted to  the  opposite  sex.  On  the  contrary  a  bisex- 
ual or,  to  use  Ferenczi's  term,  an  amphierotic  ten- 
dency is  apparent.  Thus  some  of  the  libido  takes 
a  homosexual  direction,  being  applied  (in  the  boy) 
to  the  father,  brothers,  or  other  males  in  the  fam- 
ily. This  hemophilic  application  of  the  libido  in 
infancy  corresponds  to  the  normal  friendships  and 
attachments  for  one 's  own  sex  in  the  normal  adult, 
and,  in  the  abnormal,  to  the  homosexual  perver- 
sions. 

The  holophilic  activities  of  the  infantile  period 
reach  a  high  point  somewhere  between  the  third 
and  the  fifth  years  of  life.  There  then  begins  a 
period  of  latency,  relatively  complete  in  some  in- 
dividuals, but  broken  through  in  varying  degrees 
by  expression  of  sexuality  in  others.  The  begin- 
ning of  this  period  is  marked  by  the  first  appear- 
ances of  such  reactions  as  shame,  modesty,  dis- 
gust, sympathy,  etc.  They  are  the  foundation 
and  the  forerunners  of  all  those  ethical  and  es- 
thetic forces  which  play  the  role  of  inhibitions 
upon  the  later  sexual  life  and,  like  dikes  or  dams. 


INFANTILE  SEXUALITY  17 

narrow  the  avenues  of  holophilic  expression.    The 
first  appearance  of  these  inhibitory  tendencies  is 
spontaneons    and    probably    organically    condi- 
tioned.   But  the  further  development  of  the  in- 
hibitory forces,  which  takes  place  all  through  the 
latency  period,  is  dependent  in  great  measure  for 
its  extent  and  direction  upon  the  cultural  and  edu- 
cational influences   of   the   environment.^    The 
controlling  forces  which  are  thus  shaped  by  edu- 
cational influence  and  which  eventuate  in  an  appar- 
ent disappearance,  more  or  less  complete,  of  the 
infantile  sexuality  as  manifested  in  the  flrst  period 
are  in  large  measure  developed  at  the  expense  of 
the  infantile  sexuality  itself  and  derive  much  of 
their  motive  power  from  it.    For  instance,  the 
masochistic  partial  impulse  furnishes  the  motive 
for  obedience,  and  leads  the  child  to  accept  and  to 
embody  into  his  own  personality  the  codes  or 
standards  of  those  about  him.    The  exhibitionistic 
impulse  manifested  at  first  in  the  desire  to  have  the 
body  looked  at,  later  expresses  its  energy  in  what- 
ever actions  may  serve  to  win  parental  approba- 
tion and  praise.    In  other  words  the  energy  of 
these  impulses  may  eventually  lead  the  child  to 

1  Freud  remarkB  tliat  edacation  remaiiiB  properly  within  its 
assigned  realm  only  if  it  strictly  follows  the  path  sketched  for  it 
by  the  spontaneously  appearing  inhibitory  tendencies  and  limits 
itself  to  emphasizing  and  developing  them.  The  truth  of  this 
statement  wiH,  I  think,  become  clearly  apparent  at  certain  points 
in  the  clinical  portion  of  this  book,  where  we  shall  become  ac- 
quainted with  instances  where  the  well-meant  educational  and 
correctiTe  efforts  of  parents  oyerstepped  the  limits  indicated  by 
the  spontaneous  inhibitions  and  went  too  far  in  some  directions, 
thus  producing  an  ultimate  effect  upon  the  child  that  was  very 
different  from  the  beneficial  one  intended. 


18    MORBID  FEABS  AND  COMPULSIONS 

avoid  the  very  acts  by  which  he  gratified  them  orig- 
inally. In  this  maimer  the  control  and  suppres- 
sion of  the  primitive  infantile  sexuality  is  in  large 
part  accomplished  by  motives  derived  from  the  in- 
fantile sexuaUty  itself. 

The  measures  of  libido  distributed  to  the  mem- 
bers of  the  family  or  other  persons  of  the  environ- 
ment tend  more  and  more  to  be  displaced  from  the 
sexual  aims  of  the  first  period  and  to  depart  from 
manifestations  coinciding  with  the  popular  mean- 
ing of  the  term  sexual,  taking  on  an  aspect  which 
coincides  with  the  meaning  of  love  in  its  narrow 
sense,  that  is  to  say,  affection.  The  love  for  the 
mother  thus  loses  whatever  crassly  sexual  appear- 
ance it  might  at  first  have  possessed,  whUe  the  in- 
fantile hostility  and  jealousy  exhibited  toward  the 
father  may  disappear  from  view  entirely  or  be 
represented  only  as  a  diffuse  inclination  to  disobe- 
dience, dislike  of  authority,  etc.  In  other  words 
the  manifestations  of  the  OBdipus  complex  un- 
dergo a  profound  amelioration. 

This  refining  process,  through  which  the  ener- 
gies of  the  primary  components  are  divorced  from 
their  original  aims  and  applied  to  new  aims  and 
activities  of  a  higher  and  socially  more  valuable 
order,  is  not  limited  to  the  formation  of  controlling 
or  inhibiting  trends  as  just  described  and  which  in 
large  measure  represent  the  basis  for  estheticism 
and  morality,  but  occurs  in  other  connections. 
The  primitive  sexual  curiosity  thus  becomes  a 
desire  for  general  knowledge,  the  sadistic  impulse 
finds  expression  as  a  desire  to  win  or  to  excel  in 
games,  sports  or  any  other  sort  of  competition, 


1 


INFANTILE  SEXUALITY  19 

eta  Snch  employment  of  the  primitive  energies 
for  higher  aims  is  known  as  sublimation.  The 
extent  to  which  it  occurs  in  normally  educable 
children  is  really  enormous.  We  shall  hear  some- 
thing more  of  it  later.  ^ 

The  latency  period^  as  has  been  said,  is  by  no 
means  always  complete  and  in  many  individuals 
is  occasionally  or  even  constantly  broken  through 
by  some  form  or  other  of  definitely  sexual  mani- 
festation. In  children  with  whom  this  occurs  ex- 
tensively it  often  may  be  interpreted  as  the  fore- 
shadowing of  a  later  neurosis  or  sexual  abnor- 
mality. 

A  wholly  normal  suspension  of  the  latency  oc- 
curs with  the  onset  of  puberty  and  with  it  the 
latent  period  is  terminated.  The  holophilic  in- 
stinct now  changes  from  its  infantile  to  its  adult 
form.  Hitherto  its  manifestations  have  been  pre- 
ponderantly autoerotic ;  now  begins  the  predomi- 
nance of  object  love.  Hitherto  the  various  partial 
impulses  and  zonal  pleasure  sources  existed  for  the 
most  part  side  by  side  in  a  sort  of  democratic 
equality ;  now  they  become  organized  into  a  hier- 
archy. The  genital  zone  receives  a  primacy  over 
all  the  other  components  of  the  holophilic  impulse, 
and  to  this  primacy  everything  else  (normally) 
is  subordinated.  The  partial  impulses,  looking, 
touching,  sadistic  aggression,  etc.,  and  their  pas- 
sive counterparts ;  the  oral  or  other  zones  still  sus- 
ceptible to  sexual  stimulation,  now  fall  into  the 
subordinate  role  of  fore-pleasure  production,  and 
the  whole  fore-pleasure  machinery  now  serves  the 

1  In  Chapter  IV  on  Meehaniams. 


20    MORBID  FEABS  AND  COMPULSIONS 

imified  purpose  of  preparing  for  and  urging  to- 
ward the  final  holophilio  act  through  which  sex- 
uality is  articulated  with  the  function  of  procrear 
tion,  in  the  end-pleasure  of  coitus.  Autoerotism^ 
though  in  most  cases  holding  its  ground  for  a  time 
in  the  form  of  the  masturbation  that  ordinarily  ap- 
peared about  the  time  of  puberty,  is  gradually  re- 
placed by  the  new  regime  of  object-love.  The  lib- 
ido is  eventually  withdrawn  from  its  affectionate 
fixations  upon  members  of  the  family  or  their  sur- 
rogates, and,  combining  with  the  sensual  libido 
corresponding  to  the  new  glandular  influences,  is 
at  length  transferred  to  extra-familial  individuals 
of  the  opposite  sex  with  whom,  as  foreshadowed  in 
the  masturbation  phantasies  of  puberty,  a  com- 
plete love  life  can  eventually  be  carried  out.  Only 
with  the  complete  synthesis  of  puberty  do  the  nor- 
mal differences  between  the  sexuality  of  the  male 
and  the  female  come  into  high  relief.  The  active 
or  aggressive  trends  come  to  predominate  in  the 
character  of  the  male,  the  passive  in  the  female. 
Incidentally  it  may  be  remarked  that  the  change 
at  puberty  from  infantile  to  adult  sexuality  is 
more  sharply  marked  and  more  sudden  in  the  male 
than  in  the  female.  The  love  life  of  the  female 
retains  in  perhaps  most  cases  a  good  deal  of  the 
character  of  infantile  sexuality  all  through  adoles- 
cence and  often  well  into,  or  even  throughout,  adult 
Ufe. 

This  sketch  of  the  ontogenetic  development  of 
the  holophilio  impulses  is  intended  (beyond  mak- 
ing the  reader  familiar  with  the  terminology  I 
shall  need  to  use  later)  principally  to  indicate 


INFANTILE  SEXUALITY  21 

what  is  the  normal  course  of  things.  I  shall  not 
attempt  to  discass  the  abnormalities  or  anomalies 
that  may  arise  ont  of  the  many  possibilities  for 
aberration  presented  by  the  developmental 
changes  taking  place  in  a  machinery  so  compli- 
cated. It  win  be  sufficient  at  this  point  to  say  that 
every  step  in  ontogenetic  development,  every  tran- 
sition that  must  be  passed  through,  offers  possibil- 
ities of  morbid  disturbance,  through  a  persistence 
of  this  or  that  phase  that  should  normally  be 
passed,  through  the  opening  up  of  avenues  for 
aberrant  development,  or  through  the  formation 
of  a  lotms  minoris  resistentiae  at  which  the  appar- 
ently normally  accomplished  sexual  synthesis  may 
give  way  under  the  strains  and  stresses  of  adult 
life.  Later  we  shall  gain  some  incidental  famili- 
arity with  those  partit^ular  types  of  imperfect 
synthesis  known  as  the  perversions  and  which 
correspond  to  an  over-accentuation  of  some  one  or 
more  of  the  normal  components  and  to  their  con- 
sequent failure  to  become  subordinated  to  the 
primacy  of  the  genital  zone  and  the  end-aim  of 
heterosexual  coitus.  Our  particular  study  how- 
ever concerns  another  sort  of  developmental  aber- 
ration which  we  shall  learn  to  know  as  the  nega- 
tive of  the  perversion,  namely  the  psychoneurosis. 

Before  closing  this  chapter  I  must  mention  a 
matter  that  really  belongs  under  the  heading  of 
infantile  sexuality :  the  formation  of  the  so-called 
infantile  sexual  tiieories,  which  as  we  shall  learn 
are  often  of  much  significance  in  the  determination 
of  the  psychoneurotic  symptoms  in  adult  life. 


22    MOEBID  FEAES  AND  COMPULSIONS 

Children  of  normal  intelligenoe,  about  ike  age 
of  four  or  five  ordinarily  pass  through  what  is  well 
named  the  period  of  sexual  investigation.  Previ- 
ous to  this  period  the  small  child  is  likely  to  take 
for  granted  the  existence  of  himself,  his  family  and 
his  various  neighbors  and  acquaintances,  and  dis- 
plays no  particular  curiosity  as  to  how  he  or  they 
came  to  be.  Then,  partly  tiirough  subjective  and 
partly  through  objective  influence,  a  new  and  burn- 
ing desire  for  knowledge  has  its  birth.  In  typical 
cases  this  interest  appears  as  a  reaction  to  the  ar- 
rival of  a  new  baby  in  the  family.  Such  an  event 
is  not  one  which,  by  the  average  child  of  four  or 
five,  is  looked  upon  with  favor.  On  the  contrary 
he  is  likely  to  regard  the  new-comer  as  an  unat- 
tractive intruder  with  whom  in  future  he  will  be 
compelled  to  share  his  cherished  importance,  his 
worldly  possessions,  and,  worst  of  all,  the  parents ' 
love.^  Through  the  feelings  of  hostility  bom  of 
such  considerations  the  child  is  led  to  ask  himself 
the  important  question:  ^^ Where  do  babies  come 
fromt"  in  many  cases  apparently  in  the  hope  that 
an  answer  thereto  may  place  him  in  a  position  to 
prevent  any  repetition  of  the  undesired  occur- 
rence. 

Confronted  with  this  problem  the  small  investi- 
gator naturally  turns  first  of  all  to  his  parents,  a 
source  of  aid  and  information  hitherto  found  reli- 

i  A  child  in  whose  family  no  birth  takes  plaoe  during  hb  carlj 
years  learns  of  the  dreaded  possibility  from  his  acquaintance  witii 
other  households.  Older  children  are  much  less  likely  to  be  jeal* 
ous  of  a  newly  arrived  brother  or  sister  than  are  younger  onesy 
and  in  many  cases  they  welcome  their  aniall  relatiye  with  Qft- 
mized  satUfaetion. 


INFANTILE  SEXUAL  THEORIES      23 

able.  But  in  most  cases  he  gets  little  satisfaction ; 
his  qaestipns  meet  with  a  laughing  and  evasive 
answer,  an  admonition  not  to  speak  of  such  mat- 
ters, or  some  such  interesting  statement  as  ''The 
stork  brings  the  children,"  or  ''The  doctor  finds 
them  in  the  woods."  All  such  answers  ordinarily 
affect  children  in  much  the  same  way.  The  stork 
or  the  doctor  story  is  soon  doubted,  and,  like  ad- 
monition or  evasion,  merely  serves  to  give  the 
child  the  impression  that  the  theme  of  birth  is  one 
to  be  avoided  in  the  presence  of  adults.  These 
stories,  instead  of  removing  his  curiosity,  simply 
cause  him  to  conceal  it  and  to  pursue  any  further 
investigation  in  a  less  open  and  direct  manner. 
At  the  same  time  the  failure  of  his  parents  to  aid 
and  instruct  him  in  a  matter  so  serious  to  him 
gives  rise  to  more  or  less  distinct  feelings  of  re- 
sentment, suspicion  and  distrust. 

Finding  that  the  parents  will  not  explain  birth 
for  him,  the  child  attempts  to  discover  its  explana- 
tion by  himself.  In  secret  he  ponders  the  prob- 
lem, and,  from  watching  his  elders,  from  seeing 
the  sexual  acts  of  animals,  from  the  examination 
of  his  own  body,  from  certain  physical  sensations, 
from  vague  impulses,  inclinations  and  longings 
that  begin  to  stir  witldn  him,  he  collects  material, 
and  from  it  constructs  his  own  theories  of  repro- 
duction, which,  though  grotesque  and  faulty,  are 
on  the  whole  surprisingly  near  the  truth.  The 
content  of  some  of  these  theories  we  shall  now  con- 
aider. 

Practically  all  children  who  form  any  theory 
whatever  come  to  the  rij^t  conclusion  in  the  one 


24    MORBID  FEARS  AND  COMPULSIONS 

important  particniar  that  the  baby  grows  in  the 
abdomen  of  the  mother.  It  would  seem  at  first 
thought,  that  if  children  are  able  to  gaess  this 
much  then  the  formation  of  correct  concep- 
tions of  impregnation  and  birth  would  naturally 
follow.  Yet  such  is  not  the  case,  for  by  certain 
faulty  premises  the  infant  theorist  is  led  widely 
astray.  The  first  of  these  erroneous  premises  is 
the  theory,  very  commonly  entertained,  that  every 
human  being,  female  as  well  as  male,  possesses  a 
penis.  That  among  small  boys  who  have  never 
seen  the  female  genitals  such  a  belief  should  exist 
is  of  course  not  strange.  But  even  those  who 
have  seen  the  genitals  of  some  small  female  mem- 
ber of  the  family  still  cling  to  this  notion,  and 
reconcile  their  preconceived  views  with  the  actual 
evidence  to  the  contrary  by  the  reflection :  **She  is 
still  little;  when  she  gets  older  it  will  grow." 
Some  little  girls  also  have  the  penis  theory,  for 
after  having  seen  the  male  organ,  they  conclude 
that  they  too  are  entitled  to  a  like  appendage. 
Misled  by  the  faulty  premises  involved  in  the  penis 
theory  and  by  being  ignorant  both  of  the  exist- 
ence and  of  the  functions  of  the  vagina,  the  in- 
vestigating child  is  prevented  from  guessing  cor- 
rectly the  route  by  which  the  baby  reaches  the 
outer  world.  His  most  natural  conclusion  is  that 
the  baby  must  make  its  exit  from  the  abdomen 
through  the  same  opening  as  do  the  other  solid 
products  of  bodily  activity,  in  short  that  birth 
takes  place  via  the  rectum  (the  '^ cloaca  theory").* 

1  In  this  connection  it  must  be  remembered  that  children  of  an 
age  to  form  such  theories  would  feel  toward  this  hypothesis  none 


INFANTILE  SEXUAL  THEORIES      25 

This  theory,  since  it  does  not  contain  the  con- 
cept of  anatomical  differences  between  the  sexeSi 
naturally  results  in  the  supposition  that  males 
can  bear  children  as  well  as  females. 

When  the  child  has  answered  to  his  own  satis- 
faction the  questions  of  where  the  baby  develops 
and  how  it  reaches  the  outer  world,  there  remains 
another  riddle  to  be  solved.  What  starts  the 
process  f  How  does  the  baby  get  into  the  mother  t 
The  explanation  most  obvious  to  the  child's  mind 
is,  that  since  the  baby  comes  out  like  feces,  it  must 
go  in  like  food.  Therefore  to  start  a  pregnancy 
ihe  mother  must  eat  or  drink  something,  a  fruit 
or  seed,  or  something  furnished  by  the  doctor,  and 
from  this  substance  the  baby  develops.  This  be- 
lief is  strengthened  if  the  child  learns  that  rain 
and  manure  are  required  for  i;he  proper  develop- 
ment of  seeds  planted  in  the  ground.  He  reasons 
by  analogy  that  urine  and  feces  must  be  designed 
to  favor  in  like  manner  the  development  of  a 
**baby  seed'*  within  the  abdomen. 

Another  fairly  common  theory,  which  was  first 
described  by  Beitler,  is  that  impregnation  is  ac- 
complished by  the  parents  placing  the  buttocks  to- 
gether and  blowing  flatus  into  one  another.^ 

A  notion  somewhat  different  from  these  already 
described  is  formed  by  children  who,  through  shar- 

of  the  evtiietic  objectiona  which  could  occur  to  an  adult.  ''Tlien," 
aa  Freud  aaya,  "defecation  waa  something  that  in  the  nursery 
could  be  spoken  of  without  reaenre;  the  child  had  not  yet  divorced 
himself  from  hia  oonatitutional  ooprophilic  tendendea;  it  waa  no 
degradation  to  come  into  the  world  like  a  maaa  of  CKcrement/' 
— Ueber  infantile  Sezualtheorien. 
iR.  Beittor,  ''Zentralblatt  ftir  Psychoanalyse,''  Hft  2,  1912. 


26    MORBID  PEARS  AND  COMPULSIONS 

ing  their  parents '  sleeping  room  or  in  some  other 
way,  happen  to  overhear  the  act  of  sexual  inter- 
course. From  such  an  experience  they  often  de- 
rive the  so-called  ^^ sadistic"  conception  of  coitus. 
'^They  see  in  it  something  that  the  stronger  does, 
by  force,  to  the  weaker ;  and  they  compare  it  (boys 
especially)  to  a  scuffle  such  as  those  with  which 
they  are  acquainted  from  their  association  with 
other  children."^  It  seems  probable  that  some 
children  recc^gnize  the  true  significance  of  coitus 
and  assume  a  connection  between  it  and  birth. 
But  a  larger  number  apparently  do  not  guess  this 
connection,  and,  therefore,  look  upon  the  act  sim- 
ply as  one  of  violence.  The  tendency  of  children 
to  regard  coitus  a&  a  sort  of  assault  and  battery 
committed  by  the  male  is  strengthened  if  they  see 
the  apparently  hostile  sexual  activities  of  fowls, 
cats  and  other  animals,  or  if  they  find  blood  spots 
in  the  bed  or  upon  the  linen  of  some  woman  in  the 
family.  Added  to  this  is  the  fact  that  in  certain 
homes  the  entire  married  life  presents  to  the  ob- 
servant child  the  spectade  of  continuous  strife, 
expressing  itself  in  loud  words  and  hostile  de- 
meanor. From  this  he  takes  it  as  a  matter  of 
course  that  the  quarrel  is  continued  into  the  night, 
and  is  decided  by  the  same  means  that  he  is  ac- 
customed to  employ  with  his  brothers,  sisters  or 
playmates. 

This  early  period  of  sexual  investigation  and 
theory  formation  ordinarily  comes  to  an  end  with 
the  beginning  of  the  latency  period.  The  inhibi- 
tions that  develop  at  that  time  against  matters 

iFreudy  1.  a 


INPANTILB  SEXUAL  THEORIES      27 

sexual  soon  cause  these  theories  to  fade  from  con- 
scious memory^  so  that  in  adult  life  the  individual 
is  usually  unable  to  recall  ever  having  had  any 
views  upon  or  interest  in  sexual  matters  at  this 
early  period. 

During  the  latency  period,  and  consequent  upon 
the  quiescence  of  the  investigating  instinct,  chil- 
dren often  accept  without  any  particular  conscious 
doubt  the  stories  that  babies  are  brought  by  the 
stork  or  the  doctor,  or  else  they  conclude  that  God 
makes  some  mysterious  and  supernatural  ar- 
rangement by  which  infants  appear  in  the  homes 
of  the  married.  These  beliefs  then  remain  in  con- 
scious memory  and  are  recalled  in  after  life  as  if 
they  were  the  only  ones  that  existed  in  childhood. 

In  most  children,  at  the  dose  of  the  latency 
period,  the  dormant  sexual  curiosity  again  ap- 
pears, and  a  second  period  of  sexual  investigation 
begins.  But  the  conditions  are  quite  different 
from  those  of  the  first  period.  Children  now  dis- 
cuss matters  of  sex  with  each  other ;  the  older  and 
better  informed  share  their  knowledge  with  the 
younger,  or,  occasionally,  more  or  less  complete 
sex  instruction  is  given  by  parents  or  teachers. 
Thus  in  some  cases  children  learn  the  whole  truth 
about  reproduction.  But  more  often  the  child  is 
ignorant  or  misinformed  concerning  one  or  more 
important  facts  and  so  is  prevented  from  drawing 
correct  conclusions.  Consequently  the  theories 
which  are  formed  at  this  time  are  often  extremely 
absurd  and,  because  they  are  based  upon  such 
variable  external  conditions,  of  infinite  variety. 
To  be  sure,  a  partial  revival  of  the  earlier  theories 


28    MORBID  FEAES  AND  COMPULSIONS 

may  occur  and  serve  to  color  or  modify  later  con- 
dnsionsy  bnt  the  miif  ormity  of  the  primary  and, 
so  to  spea^  endogenous  theories  no  longer  exists. 

As  these  later  theories  are  from  the  medical 
standpoint  much  less  important  than  the  earlier 
ones,  I  shall  limit  myself  to  making  little  more 
than  a  brief  mention  of  a  few  of  them*  One  of  the 
most  frequently  found  secondary  theories  is  the 
belief  that  birth  takes  place  through  the  umbilicus, 
through  the  linea  alba,  or  through  an  artificial  ab- 
dominal opening  made  by  a  doctor.  Even  grown 
women  occasionally  entertain  some  such  view. 
Such  conceptions  are  really  remnants  of  the  cloaca 
theory.  When  repression  of  the  anal  and  copro- 
philic  interests  occurs  the  original  cloaca  theory 
becomes  objectionable  and  is  excluded  from  con- 
sciousness. Then  some  less  objectionable  part 
of  the  abdomen,  such  as  the  umbilicus,  takes  in  the 
new  theory  the  place  formerly  occupied  by  the 
perineal  region. 

One  set  of  secondary  theories  depends  upon  the 
fact  that  many  children,  though  no  longer  in  ig- 
norance of  the  existence  of  the  vagina,  have  not 
yet  learned  of  the  seminal  fluid.  Hence,  in  some 
cases,  they  conclude  that  the  urine  possesses  the 
power  of  fertilization ;  in  others,  that  mere  contact 
of  the  male  and  female  genitals  (without  penetra- 
tion) is  all  that  is  necessary  for  impregnation. 
According  to  my  experience,  the  latter,  or  ^^con- 
tagion'* theory,  is  usually  found  only  among 
females.  Other  beliefs  that  may  be  mentioned 
are  the  following :  That  impregnation  results  from 
kissing,  that  coitus  takes  place  by  rectum,  that 


INFANTILE  SEXUAL  THEORIES      29 

birth  follows  invariably  or  immediately  after 
coitus,  etc.  One  of  my  patients,  apparently  be- 
lieving that  some  dose  analogy  existed  between 
human  copulation  and  the  incubation  of  eggs,  con- 
cluded that  intercourse  had  to  take  place  every 
night  for  nine  months  in  order  to  produce  a  child. 
What  significance  these  periods  of  theory 
formation  may  have  in  the  later  life  of  the  neu- 
rotic we  shall  learn  in  some  of  the  succeeding 
chapters  of  this  volmne. 


t 

J 


32    MORBID  PEARS  AND  COMPULSIONS 

fio  too  we  must  assume  the  agency  of  unseen  psy- 
chic forces  if  we  are  to  regard  the  phenomena  of 
mental  life  as  having  any  law  and  order,  or  even 
continuity  and  connectedness.  We  are  obliged  to 
posit  psychic  acts  and  influences  lying  outside  of 
the  field  of  consciousness  and  inaccessible  to  ordi- 
nary introspection — ^which  in  other  words  are  un- 
conscious. Without  this  assumption  it  is  abso- 
lutely impossible  to  reduce  things  psychic  to  any 
semblance  of  law^  order,  continuity  or  comprehen- 
sibility. 

Another  reason  for  assuming  the  existence  of 
the  non-conscious  psychic  factor  is  that  the  con- 
tent of  our  consciousness  comprises  only  an  ex- 
tremely small  portion  of  what  we  are  wont  to  call 
our  conscious  knowledge.  I  <^know"  the  multi- 
plication table,  the  date  Columbus  discovered 
America  and  an  infinite  number  of  other  things 
varying  from  the  names  of  the  twelve  apostles  to 
the  function  of  the  cerebellum;  but  the  greatest 
part  of  this  information  only  occasionally  occu- 
pies a  place  in  my  conscious  thinking,  and  then 
only  for  a  relatively  short  time.  At  all  other 
times  it  is  latent.  I  can  recall  any  portion  of  it, 
if  there  is  any  occasion  for  so  doing,  but,  unless 
attention  is  directed  to  them,  all  these  memory 
impressions  remain  unconscious  like  an  electric 
light  bulb  with  the  current  turned  oflf,  inactive, 
xmilluminated. 

Yet  even  when  they  are  inactive  we  must  at- 
tribute to  these  memory  residues  some  sort  of 
psychic  existence.  I  meet  a  man  on  the  street 
and  he  speaks  to  me.    I  recall  where  I  met  him 


PSYCHIC  CAUSES  33 

and  all  the  circumstances,  bnt  cannot  remember 
his  name.  What  t^  his  namef  Is  it  Marshall? 
No  it's  not  Marshall.  Is  it  Parsons?  No  it  is 
not  Parsons,  although  it  begins  with  a  P.  Sev-* 
eral  other  names  occur  to  me  but  I  reject  thenL 
An  hour  later  I  suddenly  recall  the  name;  it  is 
Pierson.  But  had  I  not  some  memory  of  the 
man's  name  in  the  meantime,  even  though  that 
memory  was  not  a  conscious  one?  How  can  I  tell 
what  a  man's  name  isn't,  unless  I  have  some  sort 
of  psychic  record  of  what  it  isf  And  is  not  this 
unconscious  memory  identical  in  every  respect 
with  a  conscious  memory,  save  that  it  lacks  that 
quality  which  we  know  as  awareness?  Is  it  not  a 
part  of  the  psyche,  even  when  it  is  non-conscious? 
It  has  been  maintained,  on  the  contrary,  that 
these  memory  impressions,  when  outside  of  con- 
sciousness, are  not  psychic  states,  do  not  belong 
to  mind  but  are  physical  and  pertain  to  physiol- 
ogy; that  in  other  words,  they  are  correlates  of 
somatic  processes  in  the  brain  cells,  from  which 
the  psychical  emerges  only  in  response  to  new 
stimuli  or  with  shifts  of  attention.  To  such  an 
objection  one  might,  of  course,  reply  that  they  are 
equally  entitled  to  be  called  the  residues  of  psychic 
processes,  and  that  they  are  no  more  physical  or 
physiological  than  are  conscious  psychic  activi- 
ties, which  of  course  must  be  assumed  to  have 
their  physical,  chemical  or  physiological  counter- 
parts, although  we  do  not  know  what  they  are. 
This  sort  of  argument  is,  however,  rather  sterUe. 
A  refusal  to  call  latent  memories  a  part  of  the 
psyche  is  either  a  begging  of  the  question  as  to 


34    MORBID  FEARS  AND  COMPULSIONS 

whether  only  that  which  is  conscious  is  mental,  or 
else  a  matter  of  conventional  nomenclature  which 
arbitrarily  defines  the  mind  as  that  which  is  con- 
scious. 

This  being  the  case,  the  question  of  whether 
we  should  adhere  to  the  arbitrary  and  con- 
ventional definition  of  mind  or  abandon  it  in 
favor  of  a  conception  that  includes  non-conscious 
mental  elements  is  reaUy  a  pragmatic  6ne  and 
turns  upon  which  one  of  the  two  ways  of  looking 
at  the  matter  best  accords  with  known  facts  and 
is  the  more  useful  Once  stated  in  these  terms, 
the  question  becomes  a  very  simple  one.  To  de« 
fine  mind  as  only  that  whidi  is  conscious,  and  to 
remove  from  the  field  of  psychology  the  latent 
memory  impressions  and  other  non-conscious  ele- 
ments of  which  we  are  obliged  to  infer  the  exist- 
ence, is  a  procedure  that  cannot  be  defended  from 
the  point  of  view  of  utility.  As  Freud  points  out 
it  separates  phenomena  that  are  actually  continu- 
ous, plunges  us  into  the  insoluble  problem  of 
psycho-physical  parallelism,  and  obliges  us  to 
narrow  the  field  of  psychological  investigation 
without  correspondingly  widening  any  other 
field.^  To  accept  such  a  way  of  looking  at  the 
psyche  would  be  much  the  same  as  binding  our- 
selves never  to  judge  our  fellows  except  on  the 
basis  of  what  they  say,  or  refusing  to  employ  any 
data  for  interpreting  the  behavior  of  our  friends, 
acquaintances  and  people  in  public  life  except  that 
furnished  by  what  they  choose  to  tell  us.    On  the 

iDaa   UnbewuBBten— "International   Zeitachrift  fllr   Antliche 
Psychoanalyse/'  Vol.  lU,  1916. 


UNCONSCIOUS  CAUSES  35 

other  handy  a  psychology  which  indudes  the  non- 
eonscious  is  extremely  nsefnl.  This  will,  I  feel, 
be  so  clearly  shown  in  the  following  pages  as  to 
relieve  me  of  the  task  of  arguing  the  point  jnst 
now. 

If  now  we  grant  the  right  to  posit  an  nncon- 
scions  portion  of  the  psyche,  it  is  evident  that 
hitent,  I  e.,  inactive,  memory  impressions  and 
their  like  are  not  the  only  non-consdons  mental  / 
elements  which  we  must  assnme  to  exist.  We 
have  reason  to  infer  the  existence  of  other  ele- 
ments which  are  not  simply  latent  bnt  which, 
despite  their  not  being  conscions,  are  active  and 
may  exert  an  influence,  even  a  profound  one,  on 
the  individual's  consdous  thinking  and  behavior. 
In  order  to  make  this  perfectly  clear,  let  us  sup- 
pose that  I  hypnotize  a  man  and  give  him  the  sug- 
gestion that,  fifteen  minutes  after  he  awakes,  his 
arm  will  become  completely  paralyzed.  He  is 
roused  and  remembers  nothing  of  what  I  have  said 
to  him  during  the  trance.  Nevertheless,  when 
fifteen  minutes  have  elapsed  he  is  utterly  unable 
to  move  his  arm.  He  still  has  no  recollection  of 
what  was  said  to  him  during  the  hypnotic  sleep, 
nor  does  he  realize  what  it  was  that  caused  his 
paralysis.  In  other  words,  my  suggestions,  the 
mental  impressions  causing  his  paralysis,  though 
potent  and  active  are  at  the  same  time  uncon- 
adous.  This  proves  condusively  that  a  mental 
element  does  not  necessarily  have  to  be  in  con- 
adousness  in  order  to  be  active  or  produce  an 
effect. 

A  similar  example  we  can  take  from  the  realm 


36    MORBID  FEABS  AND  COMPULSIONS 

of  the  abnormal.  A  young  woman,  a  patient  of 
the  writer's,  suffered  from  an  uncontrollable  im- 
pulse to  take  drugs.  But  the  case  was  not  one  of 
a  drug  habit  in  the  ordinary  sense,  for  the  drugs 
she  took  were  not  as  a  rule  of  the  habit  forming 
variety,  and  she  showed  no  preference  for  any  one 
drug  over  any  other.  She  did  not  take  them 
for  their  taste,  nor  for  any  pleasing  effect  they 
had  upon  her,  for  many  of  them  were  ill  tasting  or 
had  some  action  which  she  found  very  unpleasant. 
Any  substance  so  long  as  she  could  think  it  was 
<< medicine"  suited  her  just  as  well  as  any  other. 
She  had  many  times  been  questioned  as  to  why 
she  had  this  peculiar  impulse,  and  she  had  tried 
very  hard  to  find  the  explanation  herself,  but  with- 
out any  success.  The  reason  for  her  morbid 
compulsion  was  as  much  a  mystery  to  her  as  to 
every  one  else,  and  was  utterly  inexplicable  as  far 
as  the  data  furnished  by  her  consciousness  were 
concerned. 

But  while  the  compulsion  could  not  be  explained 
by  referring  it  to  anything  contained  in  the  pa- 
tient's consciousness,  our  conclusion  should  not  be 
that  it  had  no  cause,  but  rather  that  of  its  cause 
she  was  unconscious;  that  it  depended  upon  a 
mental  activity  which  lay  outside  the  field  of  her 
conscious  introspection.  It  was  just  as  if  some 
one  had  hypnotized  her  and  by  suggestion  given 
her  the  impulse  to  take  drugs,  which  upon  awaking 
she  obeyed  without  remembering  the  suggestions 
from  which  it  originated.  In  fact  such  an  impulse 
could  be  produced  for  a  time  at  least,  in  that  way. 
In  such  a  case  we  would  know  what  caused  the  im- 


UNCONSCIOUS  CAUSES  37 

pulse,  even  if  the  subject  did  not ;  in  pathologioally 
produced  compulsion  we  lack  such  knowledge  untU 
after  the  case  has  been  analyzed.  We  shall  learn 
later,  indeed,  how  it  is  possible  to  ascertain  the 
causes  even  of  these  compulsions.  In  the  case  of 
this  young  woman,  for  instance,  it  wUl  not  only 
be  shown  that  we  are  right  in  assuming  some  un- 
conscious ideas  and  impulses  as  the  real  basis  for 
her  drug  compulsion  but  also  we  shall  learn  what 
these  unconscious  ideas  and  impulses  were. 

It  should  be  understood  at  the  outset  that  we 
do  not  have  to  go  into  the  field  of  psychopathology 
or  to  such  unusual  states  as  those  induced  by  hyp- 
nosis to  find  examples  of  the  influence  of  mental 
processes  which  are  active  though  at  the  same 
time  unconscious.  Many  are  at  hand  in  the  phe- 
nomena of  every  day  experience. 

Thus  a  man's  religion  is  rarely  chosen  by  him 
only  through  conscious  reflection.  When  a  per- 
son is  a  Protestant,  it  is  ordinarily  supposed  that 
he  was  caused  to  be  so  by  what  is  popularly 
termed  his  ^  ^  bringing  up. ' '  That  is,  it  is  assumed 
that  a  large  number  of  experiences  which  he  has 
undergone,  and  of  influences  to  which  he  has  been 
subjected,  have  somehow  prejudiced  him  in  favor 
of  the  particular  religion  he  has  chosen  and  are 
really  responsible  for  his  choice.  This  does  not 
mean,  however,  that  he  rememhers  all  these  ex- 
periences or  is  clearly  conscious  that  they  are  in- 
fluencing him.  On  the  contrary  the  impressions 
having  perhaps  the  greatest  influence  are  usually 
the  ones  that  relate  to  the  moral  and  religious  in- 
struction he  received  in  childhood,  and  these  can 


38    MORBID  FEAES  AND  COMPULSIONS 

be  recalled  only  imperfectly,  and  many  of  them 
not  at  alL  It  is  obvious  therefore  that  to  explain 
why  a  person  has  accepted  a  given  religion  we 
have  ordinarily  to  assume  that  there  exists  a  non- 
conscious  biasing  agent  which  is  probably  the 
most  important  factor  in  determining  his  dioice. 

If  we  now  attempt  to  formulate  some  concep- 
tion of  this  biasing  agent  (of  this  unconscious 
cause  of  belief)  our  result  will  be  somewhat  as 
follows:  We  shall  expect  it  to  be  a  very  large 
group  of  memory  traces,  ideas  and  feelings  con- 
nected in  various  ways  with  the  central  theme  of 
religion.  Some  of  these  presumably  had  their 
origin  in  the  various  incidents  of  early  moral  in- 
struction from  the  parents,  of  intimate  family 
life,  of  childhood  visits  to  church  and  Sunday- 
school,  or  in  different  vague  perceptions  of  things 
wonderful  and  mysterious.  Others  resulted  from 
various  allied  experiences  occurring  throughout 
the  person's  later  years.  Some  of  the  elements 
of  the  group  are  doubtless  recalled  frequently, 
others  seldom,  a  great  many  others  never.  That 
is,  the  biasing  agent  consists  very  largely  of  un- 
conscious ideas.^ 

Such  a  system  of  connected  ideas,  having  a 
strong  emotional  tone,  and  displaying  a  tendency  * 

to  produce  or  influence  conscious  thought  and  ac- 
tion in  a  definite  and  predetermined  direction,  is 
called  a  complex. 

A  great  part  of  our  conscious  activities  is  de- 
termined by  such  groups  of  thoughts,  only  a  few 

1  Frink— "What  Is  a  Complex?''    JourwU  of  the  Amwieam 
MedUxa  A$900iaUim;*  Vol.  LXII,  p.  897,  1914. 


EATIONALIZATION  39 

members  of  which  are  ever  in  consciousness.  We 
have  complexes  concerning  the  different  members 
of  onr  families ;  complexes  relating  to  each  one  of 
our  important  loves,  hates,  ambitions  and  recrea- 
tions, and  complexes  concerning  our  politics, 
patriotism,  pride,  morality. 

A  statement  like  this  will  not  be  instantly  ac- 
cepted by  every  one.  According  to  most  people 
onr  thinking  is  determined  by  external  facts,  by 
our  logical  and  reasoned  judgment  of  them,  by 
what  we  know  and  perceive,  not  by  that  of  which 
we  are  unconscious.  But  though  we  do  not  un- 
derestimate the  part  played  by  logic  and  reason 
in  mental  life,  it  must  be  admitted  that  such  forces 
have  not  by  any  means  the  wholly  dominant  role 
that  is  often  unthinkingly  attributed  to  theuL 
^'When  the  emotions  are  sitting  as  judges,  facts 
make  poor  witnesses''  will  hardly  be  disputed  by 
anyone  who  stops  to  think.  We  all  have  preju- 
dices and  are  subject  to  their  influence.  ''The 
wish  is  father  to  the  thought"  applies  to  all  of  us 
at  times.  But,  common  as  the  phenomena  are, 
how  seldom  do  we  hear  a  person  admit  that  he  is 
biased  in  his  thinking,  or  see  him  give  any  evi- 
dence of  a  realization  that  such  is  the  case  I  Ask 
a  German  if  he  approves  of  Zeppelin  raids  and 
he  says:  ^'CertaiiJy."  Ask  an  Englishman  and 
he  answers:  **  Barbarism  I"  Then  ask  either  one 
of  them  to  give  the  reasons  of  his  opinion,  and 
you  will  get  a  more  or  less  logical  explanation. 
But  is  this  explanation  correct  t  Is  it  not  more 
likely  that  the  reason  that  the  German  believes  in 
Zeppelin  raids  is  that  he  is  a  German,  and  the 


40    MOBBID  FEABS  AND  COMPULSIONS 

Englishman  condemns  them  because  he  is  an 
Englishman  f  Is  it  not  practically  certain  that  in 
nine  cases  out  of  ten  the  person  is  incapable  of 
thinking  without  bias  on  a  question  so  intimately 
affecting  his  mother  country  and  himself,  and  that 
his  complexes  even  more  than  the  actual  merits 
of  the  question  are  the  main  determinants  of  his 
opinions?  But  does  the  person  himself  realize 
and  admit  this  ?  In  most  instances  certainly  not. 
On  the  contrary  he  is  sincere  in  believing  that  the 
reasons  he  gives  for  his  opinion  are  the  actual 
cause  of  his  entertaining  it. 

It  is  an  extremely  common  occurrence  that 
ideas,  beliefs,  actions,  really  having  their  origin 
in  some  one  of  the  individual 's  complexes,  and  be- 
ing at  least  partly  determined  by  ideas  and  im- 
pressions of  which  at  the  time  he  is  not  conscious, 
he  represents  to  himself  and  to  others  as  being  the 
result  of  a  logical  train  of  conscious  thought.  He 
manufactures  ex  post  f<icto  a  plausible  explana- 
tion of  his  belief  or  action  which  he  unquestion- 
ingly  accepts  as  its  cause.  This  process  of  sup- 
plying the  place  of  the  missing  (unconscious)  link 
in  the  chain  of  reasoning  with  another  (conscious) 
link  has  be^n  named  by  Ernest  Jones  rationalizO' 
tion}  It  is  because  we  all  rationalize  very  ex- 
tensively that  we  greatly  overestimate  the  role 
played  by  logical  and  reasonable  judgment  in  de- 
termining the  trend  of  our  conscious  thought  and 
conduct,  and,  to  the  same  or  even  a  greater  de- 
gree, underestimate  the  influence  and  potency  of 
those  factors  which  are  not  in  consciousness. 

1  'Tapers  on  PsychoanalyBia/'  Chapter  I. 


N 


n 


THE  FOEECONSCIOUS  41 

(b)  The  Unconscious  and  the  Foreconsdous 

Non-consdous  mental  elements  may  be  roughly 
divided  into  two  classes.  For  instance,  it  comes 
to  my  mind  as  I  am  writing,  that  the  dose  of  phos- 
phorus is  one  hundredth  of  a  grain.  I  am  sure 
that  at  any  time  since  I  first  studied  materia 
medica  I  could  have  remembered  the  quantity  of 
the  dose,  if  any  one  had  asked  me.  But  I  am  al- 
most as  sure  that  this  is  the  first  time  I  have 
thought  of  it  since  I  left  college.  Though  this 
particular  memory  was  in  the  Unconscious  all  that 
time  it  could  have  been  brought  into  my  conscious- 
ness at  any  time  if  I  had  wished  to  recall  it.  On 
the  other  hand,  the  hypnotic  subject  may  be  en- 
tirely unable  to  recall  the  hypnotist's  suggestions, 
the  neurotic  young  woman  was  absolutely  unable 
to  bring  to  her  consciousness  the  ideas  which  op- 
erated to  form  her  drug  compulsion,  nor  can  the 
German  through  any  effort  of  voluntary  intro- 
spection, become  aware  of  any  but  a  relatively 
small  portion  of  all  those  past  impressions,  going 
even  back  to  his  childhood,  which  make  up  his 
complex  concerning  the  Fatherland.  Some  un- 
conscious mental  elements,  then,  can  be  brought 
into  consciousness  at  the  will  of  the  individual; 
others  can  not,  but  remain  in  the  Unconscious  in 
spite  of  any  ordinary  effort  of  the  individual  to 
recall  them. 

Mental  impressions  or  processes  of  the  first 
class  above  mentioned  are  spoken  of  as  forecon- 
scious  and  are  said  to  belong  to  a  region  or  system 
in  the  psychic  apparatus  which  is  named  the  Fore- 


42    MOBBID  PEABS  AND  COMPULSIONS 

conscious.^  Those  of  the  second  class  are  known 
as  unconscioas  and  are  said  to  belong  to  a  system 
or  region  called  the  Unconscious.  The  word  Un- 
conscious is  often  used  to  embrace  both  systems — 
all  the  non-conscious  impressions  and  processes, 
those  of  the  Foreconscious  as  well  as  those  of  the 
Unconscious  proper.  The  mind^  then,  in  Freu- 
dian psychology,  is  conceived  as  having  three 
levels,  the  superficial  one  or  Consciousness,  em- 
bracing all  those  mental  processes  which  at  any 
given  moment  possess  the  quality  which  we  call 
awareness.  The  next,  the  Foreconscious  system 
or  level,  contains  those  elements  which  could  be 
reached  by  voluntary  introspection,  and  are  capa- 
ble of  being  brought  to  consciousness,  but  at  the 
time  lack  awareness.  The  third  and  deepest  level, 
the  Unconscious  Proper,  embraces  all  those  im- 
pressions or  processes  which  not  only  lack  aware- 
ness but  also  cannot,  by  any  unassisted  effort  of 
the  individual,  have  it  conferred  upon  them.  Ob- 
viously the  boundaries  between  the  three  systems 
are  not  sharp  or  absolute.  An  idea  that  is  con- 
scious at  one  moment  may  be  foreconscious  the 
next,  and  perhaps  eventually  unconscious.  But 
the  interchange  between  the  foreconscious  and 
consciousness  is  much  more  free  than  that  be- 
tween the  foreconscious  and  the  unconscious  or 
between  the  unconscious  and  consciousness. 

What  is  it  that  prevents  ideas  or  processes  of 
the  unconscious  proper  from  being  accessible  to 
consciousness?  Processes  belonging  to  the  un- 
conscious system  may  be  active,  and  capable  of 

1  called  preoonsciooB  by  some  writers. 


THE  FOEECONSCIOUS  43 

exerting  a  strong  inflnence  in  and  through  con- 
sciousness— ^may,  in  fact,  as  I  hope  to  show  even- 
tually, possess  nearly  every  quality  or  attribute 
of  conscious  mental  processes  save  that  of 
awareness.  What  is  it  then  that  keeps  them  from 
gaining  entrance  into  consciousness  f 

In  the  case  of  f oreconscious  processes  the  lack 
of  awareness  seems  easy  to  explain.  I  walk  along 
the  street  with  my  mind  absorbed  in  some  en- 
grossing problem.  I  have  no  true  consciousness 
of  what  is  going  on  about  me.  Nevertheless  I 
turn  the  proper  comers,  avoid  collision  with  other 
pedestrian,  and  stop  at  the  right  house.  All 
the  procenes  necessary  for  doing  these  things  are 
carried  o§  without  exciting  awareness  or  divert- 
ing my  conscious  attention  from  the  problem 
which  absorbs  it.  These  processes  are  carried  on 
in  the  foreconscious.  Not  enough  attention,  or 
better,  interest  is  distributed  to  them  to  give  them 
the  quality  of  awareness.  Yet  at  any  time  they 
could  come  into  consciousness  and  acquire  aware- 
ness if  my  interest  or  attention  were  directed  to 
them.  In  the  same  way  my  memory  impression 
of  what  is  the  dose  of  phosphorus  remained 
latent  and  in  the  foreconscious  until  attention 
and  interest  were  distributed  to  it.  When,  how- 
ever, it  was  thus  energized  or  activated,  it  came 
into  consciousness,  only  to  return  to  the  forecon- 
scious state  as  soon  as  the  activation-energy  was 
withdrawn.*  Foreconscious  memories  or  proc- 
esses seem,  then,  to  be  those  which  either  are  prac- 

U  hare  preferred  to  use  the  terms  "activatioii''  and  "aetiva- 
tloB-cnei|^   intteftd  of   "oocupation"   and   "oocnpatian-energy^ 


4A    MORBID  FEABS  AND  COMPULSIONS 

tically  unactivated  or  else  carried  on  with  such  a 
low  pressure  of  activation-energy  that  they  fail 
to  rise  above  the  threshold  of  consdonsness. 

The  lack  of  awareness  of  those  processes  be« 
longing  to  the  nnconscious  proper  cannot  be  ex- 
plained in  any  snch  manner.  When,  for  instance, 
they  produce  such  an  imperative  and  powerful 
compulsion  as  that  exemplified  by  the  young 
woman  who  was  impelled  to  take  drugs,  we  can- 
not believe  that  they  possess  only  a  low  degree  of 
activation.  On  the  contrary,  their  activation  must 
be  very  high.  We  nmst  therefore  find  some  other 
explanation  of  their  not  being  conscious  than  that 
of  a  withdrawal  of  activation  such  as  would  ac- 
count for  our  lack  of  awareness  of  the  content  of 
the  f  oreconscious. 

Of  the  little  outlays  of  money  I  make  during  the 
day,  for  carfare,  lunch,  telephone  calls,  etc.,  I 
have  no  conscious  recollection  at  night.  If  there 
were  any  occasion  to  do  so,  I  could  perhaps  recall 
how  much  I  had  spent  and  for  what  I  had  spent  it, 
but  ordinarily  these  minor  outlays  have  not  suffi- 
cient importance  to  keep  their  mental  records  long 
before  my  consciousness.  They  promptly  lose 
their  activation;  its  withdrawal  is  a  passive  and 
negative  process. 

Suppose,  on  the  other  hand,  I  pay  a  high  price 
for  a  piece  of  furniture  under  the  impression  that 
it  is  a  genuine  antique.  Hardly  do  I  get  it  home 
when  a  friend,  who  is  an  authority  on  such  mat- 
ters, demonstrates  to  me  that  it  is  not  genuine,  but 

wbieh  Brill,  the  translator  of  Freud's  works,  has  employed  as  the 
eqniyalent  of  the  German  "Besetiung*'  and  "Beseteungs-Eneigie." 


EEPEESSION  45 

a  relatively  valueless  imitation.  I  investigate 
and  find  that  the  conditions  under  which  I  bought 
it  are  such  that  I  cannot  make  the  dealer  take  it 
back  and  return  my  money.  Now  the  memory  of 
this  expenditure  does  not  quietly  and  passively 
fade  from  my  consciousness  like  the  recollection 
of  the  nickel  I  spent  for  carfare.  Instead  it  con- 
tinually intrudes  upon  me,  causes  me  to  berate 
myself  for  the  credulity  that  allowed  me  to  be 
t^en  in  so  easily,  and  keeps  me  in  a  state  of  exas- 
peration and  annoyance.  But  finally  I  say  to  my- 
seU  that  there  is  no  use  crying  over  spilt  milk. 
'^If  I  am  a  fool,  I  am,  and  that's  all  there  is  to  it.  I 
will  put  the  matter  out  of  mind  and  forget  it.  I 
refuse  to  think  or  worry  about  it  any  longer.'' 
With  an  effort  of  will  I  extrude  the  incident  from 
my  consciousness.  It  returns  again  after  an  in- 
terval but  I  again  extrude  it.  Soon  the  extrusion 
becomes  easier.  Eventually  it  is  automatic,  and 
the  memory  of  the  annoying  incident  either  en- 
tirely ceases  to  be  reproduced  in  my  consciousness 
or  else  appears  only  at  long  intervals. 

Now  it  is  obvious  that  the  process  by  which  this 
memory  is  eventually  rendered  unconscious  is 
quite  different  from  the  quiet  and  passive  loss  of 
activation  which  causes  the  f  adhig  of  the  memory 
impressions  of  insignificant  matters.  There  is 
no  passive  withdrawal  of  activation  from  my 
memory  impression  of  the  disagreeable  incident, 
at  least  not  at  first.  On  the  contrary  it  is  highly 
activated,  and  insists  upon  forcing  its  way  into  my 
consciousness  even  when  I  am  trying  to  give  my 
attention  to  other  things.    How  then  do  I  get  rid 


46    MOEBID  FEAES  AND  COMPULSIONS 

of  itt  Apparently  by  attempting  a  forcible  witlv* 
drawal  of  consdons  activation  and  by  initiating 
through  a  conscious  act  of  will  a  coumter-tictiva* 
Hon  which  is  shortly  taken  over  by  the  f  orecon* 
scions  and  becomes  automatic,  serving  to  proti^t 
me  from  the  displeasi^re  of  having  the  recoUe^ion 
of  the  disagreeable  incident  reproduced  in  my  con- 
sciousnessy  and  apparently  persisting  at  least  un- 
til the  activation  of  the  memory  itself  in  the  course 
of  time  is  eventually  withdrawn.  ^ 

This  gives  us  the  key  for  an  understanding  of 
why  it  is  that  certain  processes  of  the  Unconscious, 
in  spite  of  their  high  activation,  fail  to  gain  en- 
trance to  consciousness.  The  reason  is  that  their 
reproduction  is  opposed  by  a  counter-activation  lo- 
cated for  the  most  part  in  the  f oreconscious,  which 
automatically  and  without  involving  the  partici- 
pation of  consciousness,  keeps  them  submerged. 
The  non-consciousness  of  the  elements  belonging 
to  the  unconscious  system  is  not  then  something 
passively  conditioned,  but  the  result  of  a  positive 
and  active  counter-force. 

The  process  which  consists  of  the  withdrawal 
of  conscious  or  foreconscious  activation  from  a 
mental  element  and  which  consists  also  of  the  es- 
tablishment of  a  foreconscious  counter-activation, 
which  confines  it  to  the  Unconscious,  is  called  re- 
pression. The  mental  element  so  relegated  to  the 
unconscious  and  unable  to  return  therefrom  is 

1  strictly  speaking,  the  counter-activation  is  not  initiated  by  a 
^'oonscious  act  of  will*';  in  fact,  the  act  of  will  might  be  more 
aocorately  said  to  be  initiated  by  it.  Hie  counter-activation  is 
reaUy  represented  by  my  wish  to  forget  the  incident. 


BEFBESSION  47 

said  to  be  repressed.  The  repressing  force  im* 
peding  the  return  of  the  repressed  element  to  con' 
sciousness  is  often  spoken  of  as  a  resistance. 

The  unconscious  consists  in  large  part  of  re- 
pressed material,  though  not  everjrthing  in  the  un- 
conscious is  repressed  or  is  there  by  virtue  of  re- 
pression. The  facts  are  as  follows:  the  psychic 
apparatus  is  to  be  thought  of  after  the  model  of  a 
reflex  arc.  Thus  it  has  its  sensory,  or  afferent, 
side,  which  receives  the  stimuli  coming  from  the 
external  world  or  from  the  internal  end-organs 
excited  by  changes  within  the  body.  It  has  also 
its  efferent  side  through  which  discharges  take 
place  to  the  voluntary  muscular  apparatus  as  mo- 
tility, or  to  the  involuntary  muscular  and  glandu- 
lar systems  as  feeling  or  emotion.  The  Uncon- 
scious is  toward  the  afferent  side,  the  Forecon- 
scious  next  to  the  efferent.  All  excitations  of  the 
psychic  apparatus  (all  mental  processes)  begin 
at  the  sensory  end  of  the  system  and  are  thus,  to 
start  with,  unconscious.  ^  Some  of  them  remain 
unconscious,  while  others  pass  through  to  the 
foreconscious  and  to  consciousness  to  discharge 
ultimately  as  emotion  or  motility.  Whether  a 
given  process  remains  unconscious  or  is  allowed  to 
gain  access  to  the  foreconscious  or  to  conscious- 

1  This  is  not  ttrictly  true  unlees  we  make  the  assumption  that 
sensations  or  sense  perceptions  coming  from  the  end  organs  ap- 
plied to  the  external  world  pass  through  an  unconscious  phase. 
Freud  regards  consciousness  as,  functionally,  a  sensory  organ 
for  pereeiving  psychic  qualities.  He  speaks  of  it  as  having  two 
snrfaeesy  one  which  is  excited  by  the  stimuli  entering  through  the 
sense  organs  applied  to  the  external  world,  the  other  by  changes 
or  processes  within  the  psychic  apparatus  itself. 


48    MOBBED  FEARS  AND  COMPULSIONS 

ness  and  so  to  efferent  discharge,  depends  on 
whether  or  not  it  meets  on  its  way  with  a  resist- 
ance. For  at  the  border  line  between  the  nncon* 
scions  and  the  f oreconscions  the  repressing  forces 
or  resistances  exert  a  certain  censor-like  action. 
Mental  processes  beginning  in  the  unconscious 
have,  as  it  were,  to  undergo  an  examination  before 
they  are  admitted  to  the  higher  psychic  degrees 
or  systems.  Depending  on  their  character  or 
qualities  (a  matter  of  which  we  shall  hear  more 
later)  ^  some  of  them  are  rejected,  and  remain  re- 
pressed and  in  the  unconscious ;  others  are  allowed 
to  pass  to  the  f oreconscions  system  from  which 
they  may  or  may  not  enter  consciousness.  In 
normal  conditions  the  f  oreconscions  system  must 
be  traversed  before  an  excitation  gains  discharge 
as  affectivity  or  motility.  The  most  important 
function  of  tbis  system  is  that  of  opening  or  clos- 
ing the  avenues  to  such  discharge.  The  content 
of  the  unconscious  is,  then,  made  up  of  latent  (un- 
activated)  psychic  formations,  mental  processes 
that  are  in  statu  nascendi,  and  other  processes  or 
activated  impressions  which  are  not  allowed  to 
pass  the  censor  and  are  thus  repressed.  We  shall 
consider  the  content  of  the  unconscious  from  a 
different  point  of  view  later.*  At  present  we 
must  devote  ourselves  to  gaining  a  clearer  under- 
standing of  repression,  its  function  and  the  motive 
for  it. 

A  repressed  element,  as  I  have  indicated,  is  one 
from  which  conscious  and  foreconscious  activa- 
tion is  withdrawn  (if  the  element  ever  possessed 

iPage57.  sPltge62. 


CONSCIENCE  49 

such  activation)  and  against  which  a  connter-ac- 
tivation  exists  in  the  f  oreconscions.  Its  activa- 
tion^  if  it  has  any,  belongs  entirely  to  the  uncon- 
scions  system*  What  is  the  purpose  of  this  proc- 
ess t  Why  is  anything  ever  repressed?  We  get 
a  hint  of  the  answer  to  this  question  from  the 
example  I  have  given.  I  repressed  the  recollec- 
tion of  my  being  taken  in  by  the  furniture  dealer 
because  this  memory  was  annojdng  me,  and  giving 
me  displeasure,  for  the  most  part  apparently  be- 
cause it  showed  me  in  such  a  light  as  to  injure  my 
self -esteem.  That  is  to  say,  we  get  the  suggestion 
that  repression  is  a  protective  mechanism,  that 
its  motive  is  the  avoidance  of  pain,  or  a  painful 
feeling.  This  is,  in  fact,  the  correct  explanation. 
The  function  of  repression  is  that  of  defending 
the  ego  against  those  ideas  or  processes  which  are 
incompatible  with,  and  painful  from  the  point  of 
view  of,  the  main  trends  of  the  individual 's  con- 
scious thought  and  feeling.  This  means  in  gen- 
eral that  the  elements  in  question  depend,  for 
their  power  to  cause  pleasure  or  pain,  upon  their 
being  out  of  accord  with  his  individual  ethico-es- 
thetic  ideals  and  impulses  and  upon  their  militat- 
ing against  his  self-satisfaction  and  self-esteeuL 

(c)  Repression  and  the  Psychology  of 

Conscience 

Since  the  concept  of  repression  is  one  of  the 
most  vital  in  psychoanalysis  we  must  consider  it 
in  greater  detail  But  to  get  a  fuller  appreciation 
of  it,  we  have  to  depart  from  the  somewhat  meta- 
psydiological  point  of  view  which  we  have  been 


50    MORBID  FEAES  AND  COMPULSIONS 

occupying  and  approach  the  subject  from  another 
angle.  This  will  involve  what  may  seem  a  con- 
siderable digression,  though  on  i^e  whole  our 
course  will  be  one  of  progress. 

In  the  first  years  of  childhood  there  is  nothing 
resembling  that  which  in  the  adult  we  call  self-con- 
trol. The  infant  fulfills  every  wish  he  has,  if  it 
is  physically  possible  for  him  to  do  so.  There  is 
no  subjective  restraint,  no  inhibition  arising  from 
within,  to  oppose  or  interfere  with  anything  he 
wants  to  do.  He  knows  no  shame,  no  disgust, 
nothing  resembling  morality.  He  has  no  motives 
save  those  of  getting  immediate  pleasure  or  avoid- 
ing immediate  pain.  Of  pains  and  pleasures  tem- 
porally and  spatially  remote  he  takes  no  cogni- 
zance ;  they  mean  notlung  to  him.  His  behavior 
consists  solely  of  simple  responses  to  the  stimuli 
of  his  environment,  and  of  expressions  of  the  va- 
rious tendencies  of  the  hereditary  instincts,  the 
self -preservative,  and  the  rudimentary  sexual. 

As  we  have  seen,  ^  a  different  state  of  affairs  is 
initiated  with  the  beginning  of  the  period  of  lat- 
ency, somewhere  about  the  third  year.  There 
then  appear  certain  inhibitory  impulses  or  reac- 
tion-tendencies:  shame,  disgust,  sympathy  and  a 
rudimentary  morality.  ^  These  new  tendencies  to 
some  extent  oppose  and  limit  the  freedom  of  ex- 
pression previously  enjoyed  by  the  primary  in* 

1  Chapter  I.         ' 

a  These  reaotions  which  appear  spontaiieoiuly  do  not  for  the 
moBt  part  bring  with  them  their  objeet.  That  is  to  say:  they 
are  first  represented  by  a  capacity  for  such  responses.  The  type 
of  situation  or  condition  which  provokes  the  actual  response  is 
determined  in  large  part  by  education  and  environment. 


CONSCIENCE  51 

stinctive  impulses.  Situations  and  reactions  that 
formerly  were  wholly  pleasnre-giving  now  be- 
come, to  a  varying  extent,  sources  of  displeasure. 
Thus  acts,  like  running  around  naked,  so  much 
enjoyed  by  young  children,  which  gave  pure 
pleasure  through  gratification  of  the  exhibition- 
istic  impulse  now  provoke  the  displeasure  of 
shame  or  embarrassment;  those  acts  which,  like 
torturing  animals  and  teasing,  gratified  the  sadis- 
tic impulse  now  give  rise  to  feelings  of  sympathy 
or  moral  repugnance,  etc.  The  possibility  of  in- 
ternal conflict  has  been  introduced  into  the  psy- 
chic life. 

In  this  way  comes  about  the  first  repression. 
An  impulse,  when  opposed  by  one  of  the  newly 
developed  counter  impulses  in  such  a  way  that  ex- 
pression of  it  gives  a  greater  amount  of  displeas- 
ure than  pleasure,  shortly  disappears  from  view. 
In  other  words,  it  is  repressed.  The  activation 
energy  which  it  originally  possessed  (its  Kbido,  if 
it  is  a  question  of  a  psycho-sexual  impulse)  is  with- 
drawn ;  a  counter-activation,  corresponding  to  the 
inhibiting  trend,  appears  in  place  of  it. 

The  beginning  of  repression  is  the  beginning  of 
the  Unconscious,  as  such.  In  early  infancy  there 
is  no  differentiation  into  systems,  just  as  there  is 
no  repression.  The  first  repressed  elements  form 
the  nucleus  of  the  unconscious.  To  them  is  added 
all  that  which  later  succumbs  to  repression  in  the 
course  of  the  psychic  development  of  the  indi- 
vidual. 

But  the  process  of  repression  is  not  all  so  sim- 
ple as  that  which  we  have  described  as  the  first 


52    MOEBID  FEARS  AND  COMPULSIONS 

repression.  Though  the  avoidance  of  pain  or  dis- 
pleasure is  throughout  the  immediate  motive  for 
repression  (whether  the  element  repressed  be  a 
wish-presentation  or  a  memory)  the  sources  of 
such  displeasure  are  not  to  be  found  solely  in  the 
hereditary  and  spontaneously  arising  inhibitory 
reactions,  as  we  shall  presently  see. 

There  is  in  childhood  a  certain  phase  of  develop- 
menty  (the  existence  of  which  is  better  demon- 
strated by  some  of  the  pathological  conditions  of 
adult  life  than  by  direct  observation  of  the  child) 
which  is  known  as  the  phase  of  Narcissism.  It  is 
a  transitional  phase  interposed  between  the  pre- 
dominant autoerotism  of  infancy  and  the  later 
state  of  object  love,  and  partakes  of  the  nature  of 
each.  It  is  distinguished  by  the  fact  that  the 
individual's  holophilic  impulses  and  interests 
are  for  the  time  being  directed  toward  himself^ 
in  mudi  the  same  manner  that  in  the  adult  they 
are  directed  toward  another  person.  That  is  to 
say,  the  child  is  for  a  time  his  own  sexual  object ; 
he  loves  or  is  in  love  with  himself. 

Subsequent  to  this  tpansitional  phase  in  the  psy- 
cho-sexual development,  the  mam  streams  of 
libido  are  withdrawn  from  the  self  and  applied  to 
sex  interests  and  objects  of  the  external  world. 
But  not  all  the  libido  is  so  employed.  Some  of  it 
remains  directed  self  ward,  though  not  now  to  the 
real  self  primarily,  but  rather  to  an  ideal.  The 
complete  self-satisfaction  which  the  child  enjoys 
during  the  phase  of  primary  narcissism,  when  he 
is  his  own  ideal,  he  can  not  long  retam.    Admoni- 


CONSCIENCE  53 

tions  and  criticisms  from  the  parents,  Ms  observa* 
tion  of  the  people  about  him  and  the  comparisons 
he  makes  of  himself  with  them  soon  give  him  a 
sense  of  imperfection  and  disturb  his  self-content- 
ment. Thus  he  begins  to  desire  to  be,  in  certain 
respects,  what  actually  he  is  not ;  to  have  qualities 
which  actually  he  lacks ;  to  be  rid  of  traits  which 
in  fact  he  possesses.  He  forms,  in  other  words, 
an  ideal  for  himself,  of  what  he  would  like  to  be, 
and  to  this  ideal  that  portion  of  the  libido  remain- 
ing in  selfward  distribution  is  now  transferred. 
In  so  far  as  he  can  bring  his  real  self  into  corres- 
pondence with  this  ideal  of  self,  his  narcissistic 
libido  is  gratified,  and  in  a  measure  he  regains  the 
self-satisfaction  he  formerly  enjoyed.  On  the 
other  hand,  to  whatever  extent  a  disparity  is  per- 
ceived between  the  real  self  and  the  ego-ideal,  to 
that  extent  the  narcissistic  libido  fails  of  gratifica- 
tion and  remains  free,  as  some  form  of  self -dissat- 
isfaction or  discontent. 

What  later  becomes  an  ego-ideal  was  at  first 
an  external  critique.  The  control  which  the  child 
primarily  exercises  through  fear  of  his  parents' 
disapproval  (or  punishment)  he  eventually  main- 
tains through  fear  of  his  own  disapproval.  Such 
terms  as  right  and  wrong,  proper  and  improper, 
at  first  mean  nothing  to  him  in  and  for  themselves. 
He  would  just  as  soon  do  a  thing  labeled  "wrong" 
as  one  labeled  ** right,"  if  it  were  equally  pleasur- 
able. But  with  one  group  of  terms  he  learns  to 
associate  displeasure  in  the  shape  of  disapproba* 
tion  or  punishment  from  the  parents;  with  the 


54    MORBID  FEAES  AND  COMPULSIONS 

other,  pleasure  in  the  form  of  rewards  and  praise ; 
and  he  begins  to  avoid  actions  belonging  to  the 
first  category  and  to  cultivate  those  of  the  second 
purely  because  of  the  extrinsic  consequences  of  so 
doing.  But  gradually  the  external  standards  are 
assimilated.  To  do  ^' wrong"  begins  to  mean  not 
only  to  be  less  loved  but  to  be  less  lovable. 
"Eight,'*  **proper'*  and  **nice''  connote  not  sim- 
ply praise  but  to  be  praiseworthy. 

Just  as  the  first  specifications  of  the  ideal  are 
founded  on  considerations  of  what  would  win  or 
lose  parental  approval  and  love,  so  later  contri- 
butions to  it  have  their  origin  in  the  desire  to  be 
thought  well  of  by  one's  teachers,  by  admired  or 
respected  persons,  by  one's  fellows  and  by  the 
general  public.  Thus  the  essentially  homosexual 
libido,  originally  (in  the  boy)  the  desire  for  the 
approval  of  his  father,  contributes  largely  to  the 
formation  of  the  ego-ideaL 

The  narcissistic  libido,  and  that  portion  of  the 
homosexual  libido  directed  toward  the  self,  find 
their  satisfaction  through  the  individual's  bring- 
ing (or  thinking  he  brings)  his  real  self  into  cor- 
respondence with  the  ideal  he  has  made  for  him- 
self. This  gratification  is  what  we  know  as  self- 
satisfaction,  self-esteem  and  self -content,  the 
pleasures  of  self-respect,  of  moral  or  esthetic  self- 
satisfaction.  If,  however,  a  disparity  is  per- 
ceived between  the  real  self  and  the  specifications 
of  the  ego-ideal,  a  portion  of  the  self  ward  directed 
libido  fails  of  satisfaction,  remains  a  free  tension 
or  yearning,  and  is  felt  as  shame,  guilt,  humilia- 
tion or  a  sense  of  inferiority.    The  free  homosex- 


EOO-IDEAL  55 

nal  libido  is  converted  into  anxiety  ^  and  is  per- 
ceived as  a  fear  of  the  public  (shynesSi  diffidence, 
self -consciousness)  or  a  fear  of  ^*the  father" 
(self-consciousness,  etc.,  before  men  who  are  older 
or  distinguished  or  in  positions  of  authority  and 
who  are  therefore ,  unconsciously  identified  with 
the  father). 

We  perceive  at  this  point  that  what  we  have 
really  been  talking  about  is  the  psychology  of  con* 
science.  Conscience  is  nothing  other  than  a  cen- 
sorial function  or  ^'instance''  of  the  psyche  which 
performs  the  task  of  watching  over  and  insuring 
the  gratification  of  our  narcissistic  libido  by  warn- 
ing us  of  any  disparity  existing  between  an  im- 
pulse or  contemplated  action  and  the  specification 
of  the  ego-ideal.  The  inner  voice  which  torments 
us  with  **You  must"  and  **You  must  not"  was 
primarily  the  voice  of  the  parents,  later  of  our 
teachers  and  those  about  us,  from  whose  verbally 
conveyed  praise  or  dispraise  we  built  up  the  struc- 
ture of  our  personal  moral  and  esthetic  ideals. 

In  the  symptoms  of  certain  pathological  states, 
notably  paranoia,  the  developmental  history  of 
conscience  is  seen  regressively  reproduced.  The 
patient  complains  that  some  one  knows  all  his 
thoughts,  and  watches  and  foresees  all  his  actions. 
He  hears  the  voice  of  this  person  continually  com- 
menting and  criticising.  At  times  it  reviles  him, 
accuses  him  of  foul  thoughts,  of  abnormal  prac- 
tices. In  some  cases  the  voice  seems  to  be  that  of 
some  particular  man,  especially  an  elderly  man. 

iSee  Chapter  VII  for  the  reUtion  between  free  deaire  and 
uudety. 


58    MORBID  FEAES  AND  COMPULSIONS 

tion  with  what  is  ineligible  and  already  repressed. 

Let  us  again  point  out  that  the  purpose  of  re- 
pression is  in  every  case  the  avoidance  of  displeas- 
ure or  pain.  Those  elements^  whether  they  be 
wishes,  memories  or  ideas,  are  repressed  which,  if 
admitted  to  or  retained  in  consciousness,  would 
create  a  sense  of  disparity  between  the  real  self 
and  the  ideal,  and  deprive  some  of  the  nardssistio 
libido  of  its  gratification,  would  in  other  words 
lower  the  individual  in  his  own  eyes,  and  subject 
him  to  the  displeasure  of  a  loss  of  self-respect  or 
the  tortures  of  a  guilty  conscience. 

The  term  conscience,  as  it  is  ordinarily  used, 
implies  an  endopsychic  censorship  which  deals 
with  moral  matters  almost  exclusively.  But  the 
ego-ideal  contains  many  other  specifications  than 
merely  moral  ones,  and  self-satisfaction  has  other 
components  than  simply  moral  self -content.  Our 
self-satisfaction  is  disturbed  quite  as  much  by 
non-moral  disparities  between  the  ego  and  the 
ideal  as  by  strictly  moral  ones,  and  in  either  case 
the  narcissistic  libido  is  freed  in  just  the  same 
way,  and  the  type  of  displeasure  experienced  has 
essentially  the  same  quality.  To  use  the  wrong 
fork  at  a  formal  dinner,  to  pass  flatus  in  public 
accidentally,  to  make  a  serious  mistake  in  diag- 
nosis, or  to  have  on  dirty  underwear,  are  not  mat- 
ters that  can  be  classed  as  sins,  though  in  certaia 
circumstances  they  can  produce  a  sense  of  shame 
and  humiliation  which  has  no  essential  qualitative 
difference  from  that  produced  by  actions  which 
the  individual  does  regard  as  sinful  or  immoral. 
We  are  apprised  of  incompatibility  between  a 


EGO-IDEAL  59 

wish  or  contemplated  action  and  the  esthetic,  am- 
bitions or  grandiose  specifications  of  the  ego-ideal 
apparentiy  in  jnst  the  same  way  and  by  jnst  the 
same  function  as  that  which  applies  in  matters 
etbicaL  It  would  seem  then  not  only  convenient 
but  justifiable  to  broaden  the  term  conscience  to 
include  not  only  that  which  measures  the  self  ac- 
cording to  the  purely  ethical  terms  of  the  ideal,  but 
also  that  which  does  all  such  self-measurings 
whether  they  be  according  to  moral,  esthetic,  am- 
bitious, patriotic  or  any  other  variety  of  ego-ideal 
specifications.  ^ 

If  we  ask  a  person  (or  ourselves,  for  that  mat- 
ter) :  What  is  your  ego-ideal  t  What  are  the 
standards  and  specifications  that  you  try  to  live 
up  tot  we  are  not  likely  to  get  a  satisfying  answer. 
Some  would  say  frankly  that  they  could  not  an- 
swer such  a  question.  Others  might  attempt  to 
formulate  their  standards  for  us,  and  perhaps  feel 
that  they  had  succeeded  in  doing  so.  But  in  such 
a  case,  if  we  had  a  chance  to  observe  the  person 
further,  we  would  see  that  he  does  things  that 
are  entirely  contrary  to  the  standards  he  stated, 
yet  without  displaying  any  sign  of  unpleasant 
emotion  or  appearing  to  suffer  any  loss  of  self- 
esteem;  while  certain  other  acts  which  are  per- 

1  Perhaps  it  ahould  be  pointed  out  that  the  specificatione  of  the 
€go-ideal  are  not  neceesarily  oonsietent  with  each  other.  Thus, 
one  of  mj  patients,  who  in  company  with  a  friend  ''picked  up"  a 
eoaple  of  proetitntee,  felt  ashamed  to  go  to  a  hotel  to  spend  the 
night  with  them»  yet  almost  as  much  ashamed  to  back  out.  A 
man  who  would  be  ashamed  to  appear  irreligious  may  also  feel 
ashamed  to  say  his  evening  prayers  in  the  presence  of  another 
man  who  occapies  a  room  with  him. 


60    MORBID  FEAES  AND  COMPULSIONS 

f  ectly  in  accord  with  any  standards  he  mentioned 
seem  nevertheless  to  cause  him  acute  shame  and 
humiliation  and  seriously  to  injure  his  self -con- 
tent 

Observations  like  this,  if  carried  far  enough^ 
teach  us  two  important  things :  first  that  a  mere 
intellectual  acceptance  of  a  given  action  as  right 
or  as  wrong  does  not  constitute  an  incorporation 
of  that  judgment  into  the  specifications  of  the  indi- 
vidual's  ego-ideal.  A  person  may  say  and  really 
believe  that  we  ought  to  return  good  for  evil  and 
yet  not  feel  the  slightest  compunction  or  self-re- 
proach when  he  fails  to  do  so.  Nor  does  an  intel- 
lectual rejection  of  a  given  moral  code  mean  that 
it  has  ceased  to  exist  as  one  of  the  stipulations  of 
that  individual's  ego-ideal.  Thus  one  of  my  pa- 
tients, an  ardent  feminist,  railed  against  marriage 
and  advocated  free  love,  asserting  that  as  soon  as 
she  became  entirely  self-supporting,  she  would 
enter  such  a  relationship.  Nevertheless  when  at 
length  she  came  to  the  point  of  actually  putting 
her  long  contemplated  plan  into  execution,  she  was 
overcome  by  a  spasm  of  moral  repugnance  and 
broke  out  with  a  neurosis. 

Thus  for  a  given  code  or  standard  to  be  a  part 
of  the  ideal  means  not  an  intellectual  but  an  emo- 
tional, not  a  descriptive  but  a  dynamic  acceptance 
of  it ;  it  means,  on  the  other  hand,  that  consider- 
able libido  is  attached  to  it  and  that  it  has  expe- 
rienced an  incorporation  into  the  individuaPs  per- 
sonality. Observation  shows  that  impressions  re- 
ceived in  early  childhood  are  the  most  potent  in 
determining  what  sort  of  an  ideal  the  individual 


EGO-n^^EAL  61 

fashioiis.  Later  experiences  which  contribute  to 
the  ideal  or  modify  its  specifications  as  a  role  gain 
their  power  to  do  so  through  some  sunilarity  or 
associative  connection  with  the  earlier  impres- 
sions or  the  persons  making  them. 

The  second  important  fact  that  is  brought  out 
by  questioning  people  as  to  the  nature  of  the  ego* 
ideal  they  possess  is  that  the  ideal  is  not  con- 
sciously formulated.  They  can  give  some  of  its 
si>ecification8  very  readily,  but  are  unable  to  draw 
a  definite  word  picture  of  it.  The  ego-iddal  is  not 
a  conscious  formation.  For  the  most  part  it  be- 
longs to  the  foreconscious  system.  Nobody  is 
continuously  or  completely  conscious  of  what  his 
ego-ideal  is,  though  perhaps  the  major  portion  of 
it  (even  if  not  definitely  formulated)  is  accessible 
to  consciousness  in  accordance  with  the  demands 
of  any  given  inmiediate  situation. 

It  should  be  added  that  the  foreconscious  sys- 
tem is  the  seat  not  only  of  the  ego-ideal  but  of  all 
the  rest  of  the  controlling  trends  which  distin- 
guish civilized  man  from  the  savage  and  the  con- 
stitutional criminal,  and  adapt  his  thinking  and 
behavior  to  the  demands  of  civilized  life.  It  is  the 
system  which  in  the  main  brings  about  and  main- 
tains repression. 

I  have  spoken  of  the  existence  of  a  censor  be- 
tween the  unconscious  and  the  foreconscious, 
which  determined  the  eventual  admissibility  or 
inadmissibility  to  consciousness  of  the  mental 
processes  starting  in  the  imconscious.  By  the 
term  censor  was  not  meant  any  separate  psychic 
entity  but  rather  the  effect  exercised  by  the  trends 


62    MOEBID  FBAES  AND  COMPULSIONS 

of  the  f  oreconscions  upon  the  tmoonsoious  activ- 
ities impinging  upon  their  lower  sorf ace.  ^  The 
action  of  this  censor  we  can  now  identify  with  the 
action  of  conscience  (I  am  here  using  the  word  in 
the  broad  sense  in  which  I  earlier  defined  it).  At 
the  same  time  I  recognize  that  the  censoring,  re- 
jecting and  repressing  action  which  conscience  ex- 
ercises upon  wishes  and  ideals  that  press  toward 
conscious  representation  and  ei^ression  does  not 
have  to  be  deferred  until  the  elements  in  question 
have  already  entered  consciousness,  and  is  not 
limited  to  ejecting  and  expelling  them  therefrom 
after  they  have  entered,  but  may  be,  and  exten- 
sively is,  exercised  still  earlier,  and  may  entirely 
prevent  the  presentations  from  reaching  con- 
sciousness. Consciousness  does  not  participate 
in  any  but  relatively  a  small  number  of  the  acts  of 
rejection  and  repression. 

(d)  The  Content  of  the  Unconscious 

From  what  has  been  said  about  the  development 
of  conscience  and  of  the  role  of  the  f  oreconscions 
as  a  controlling  and  repressing  system,  we  get  the 
suggestion  that  the  unconscious  or  the  nucleus  of 
it  must  represent  something  existing  in  the  psy- 
chic apparatus  from  the  beginning,  while  the  fore- 
conscious  must  develop  gradually  in  the  course  of 
life.  This  is  found  to  be  the  fact.  The  uncon- 
scious is  the  primitive  both  phylogenetically  and 
ontogenetically.  It  represents  that  which  is  un- 
controlled in  the  savage  but  controlled  in  the  civi- 

1 1  hope  to  be  excused  for  using  such  meduuDlstio  phiaMology 
la  the  discossioii  of  such  intangible  mattera. 


CONTENT  OP  UNCONSCIOUS        6^ 

lized;  what  is  uncontrolled  in  the  child  bnt  con- 
trolled in  the  adult.  The  f oreconscious  repre- 
sents all  that  is  introduced  in  the  higher  stages  of 
the  evolution  of  civilized  man  out  of  the  savage, 
and  of  the  adult  out  of  the  infant.  This  is  true 
not  only  in  the  sense  that  the  content  of  the  uncon- 
scious consists  largely  of  trends  or  tendencies  to 
action  that  are  more  primitive  than  those  of  the 
higher  psychic  systems,  but  in  the  sense  that  the 
mental  processes  themselves,  the  ways  of  thinking, 
are  also  more  primitive.  ^ 

The  content  or  nature  of  the  unconscious  as 
compared  to  the  higher  systems  will  be  made 
clearer  by  the  consideration  of  the  following  ex- 
ample. A  friend  once  came  to  me  to  ask  advice 
about  a  neurotic  young  woman  in  whom  he  was 
much  interested.  The  girl  was  an  only  child  of  a 
widowed  mother  who  was  not  in  the  best  of  health 
or  of  financial  circumstances.  The  mother 
showed  the  utmost  devotion  to  the  girl,  thought 
only  of  her,  and  never  hesitated  to  make  any  sac- 
rifice, no  matter  how  great,  if  her  daughter  de- 
manded it,  or  if  it  promised  in  any  way  to  contrib- 
ute to  the  girPs  health  or  happiness.  The  daugh- 
ter, my  friend  said,  was  equally  as  fond  of  the 
mother.  She  was  always  praising  her  mother, 
worrying  about  her  health,  and  bemoaning  the 
fact  that  she  had  been  the  cause  of  so  much 
anxiety,  and  could  make  so  little  return  for  her 
mother's  sacrifices  in  her  behalf. 

Yet  strangely  enough  all  the  many  attempts 
she  was  continually  making  to  relieve  her  mother 

iSee  CliApter  III— Tlie  Two  Kinds  of  Thinking. 


64    MORBID  FEARS  AND  COMPULSIONS 

of  some  of  her  burdens,  and  be  a  help  and  comfort 
to  her,  invariably  came  to  naught,  and  in  many 
instances  had  just  the  reverse  of  the  happy  effect 
for  which  they  seemed  to  be  intended.  For  in- 
stance the  girl  at  one  time  had  a  physical  illness 
which  left  her  in  a  very  much  incapacitated  condi- 
tion and  required  her  to  go  to  the  country  to  regain 
her  strength.  The  mother  succeeded  in  finding 
a  satisfactory  place  for  the  daughter  where  at  a 
very  small  expense  she  could  remain  until  her 
convalescence  was  complete.  The  girl  seemed  to 
improve  quite  rapidly,  and  the  mother  was  de- 
lighted. Very  shortly  however  the  girl  returned 
home.  She  could  not  bear,  she  said,  to  be  away 
from  her  mother  any  longer.  She  felt  she  must 
be  home  to  help  her  mother,  to  relieve  her  strain 
and  to  avoid  expense.  Compared  to  her  mother's 
welfare  her  own  health  was  nothing. 

The  fact  is  that  this  return  home  had  upon  the 
mother  just  the  opposite  effect  to  that  for  which 
it  seemed  to  be  intended.  Instead  of  helping  her 
mother  and  allowing  her  to  rest,  the  girl  caused 
more  work  and  more  worry  by  being  home  than  by 
remaining  away.  She  saved  no  expense  by  being 
home  for  it  cost  less  to  keep  her  away  than  at 
home;  because  when  she  was  home  she  was  so 
helpless  that  her  mother  had  to  hire  an  extra  serv- 
ant. And  by  delaying  her  convalescence  she  pro^ 
longed  what  was  the  immediate  cause  of  her 
mother's  anxiety.  This  is  only  a  sample  of  many 
instances  of  a  similar  character  where  by  attempt- 
ing to  make  life  easier  for  her  mother  she  actually 
made  it  harder. 


CONTENT  OF  UNCONSCIOUS         65 

In  comineiitiiig  npon  these  things  my  friend  said 
^th  exasperation :  ^^The  girl  acts  as  if  she  wanted 
to  make  trouble  for  her  mother^  as  if  she  hated  her 
and  was  not  satisfied  to  let  her  have  a  moment's 
peace  or  happiness.  But  to  say  such  a  thing  is 
absurd,  for  I've  told  you  how  fond  she  really  is  of 
her  mother." 

Yet  what  my  friend  said  was  not  as  absurd  as 
he  thought  it.  In  a  way  he  had  interpreted  the 
girl's  behavior  oorreotly,  only  he  took  no  account 
of  the  unconscious.  The  obvious  fact  of  the  girl's 
protestations  of  love  for  her  mother  made  him 
reject  this  interpretation.  His  statement  (that 
the  girl  acted  (is  if  she  hated  her  mother;  as  if  she 
wanted  to  make  trouble) ,  was  right  as  far  as  it 
went.  But  where  he  said  as  if  she  hated,  he 
should,  to  be  entirely  correct,  have  said  tmcoii- 
sciously. 

In  the  normal  person,  the  f  oreconsdous  and  con- 
scious systems  dominate  the  avenues  to  motor  dis* 
diarge — ^to  affectivity  or  action.  *  Only  those  im- 
pulses or  excitations  which  are  in  accord  with  the 
trends  of  the  f oreconsdous,  and  which  pass  its 
censorship  are  given  efferent  expression.'  But  in 
cases  such  as  that  of  this  young  woman  the  sway 
of  the  higher  psychic  systems  is  imperfect.  Im«- 
pulses  which  normally  belong  to  the  unconscious 
and  are  repressed  perfectly  are  here  not  fully  con- 
trolled but  find  their  way  to  action.  The  effects 
of  these  actions  indicate  the  quality  of  the  uncon- 

1  Of  this  I  dian  hare  more  to  say  later.    Chapter  VI. 
tXhe  higher  {Mychic  syBteniB  control  only  the  form  of  the  ez- 
pnukaoL  id  the  mge  aod  not  its  quantity  or  oontinuougnesB. 


66    MOBBID  FEABS  AND  COMPULSIONS 

scious  processes  which  furnish  their  motivation. 
From  these  ^^as  if  8*^  of  the  girPs  conscious  life 
we  learn  the  Is  of  the  onconscions. 

As  far  as  the  consciousness  and  f oreconsdous 
of  the  girl  were  concerned  she  had  a  real  tod 
great  love  for  her  mother.  But  unconsciously  she 
hated  her  and  did  desire  to  make  her  unhappy.  If 
we  seek  to  learn  how  this  strange  state  of  affairs 
came  to  be  so,  we  get  a  good  deal  of  information 
about  the  unconscious.  We  see  first  that  the  un* 
conscious  is  primitive.^  The  hostile,  vindictive 
reactions  constantly  expressed  in  the  girl's  be- 
havior are  not  what  we  expect  from  a  cultured  civ- 
ilized woman  under  any  normal  circumstances  but 
are  more  in  keeping  with  the  cfaaracter  of  an 
American  Lidian  or  any  other  savage. 

In  the  second  place  we  see  that  the  unconsdous 
has  no  regard  for  reality.  It  was  not  to  the  girl's 
ultimate  advantage  to  make  her  mother  miserable. 
Nor  was  hate  the  appropriate  emotion  for  the 
actual  situation.  The  mother  was  devotion  and 
kindness  itself ;  so  why  should  her  daughter  hate 
herf  The  ethical  values  of  the  situation  were 
entirely  ignored. 

In  the  third  place,  if  we  go  far  back  into  the 
girl's  psychic  histdry  (to  her  childhood,  in  fact), 
we  find  that  there  was  a  time  when  hostility  to- 
ward the  mother  was  an  emotion  not  so  entirely 
senseless  as  it  seemed  later.  For  as  a  little  child 
the  girl  was  greatly  attached  to  her  father  and 
envied  the  position  the  mother  occupied  with  him. 

^  I  may  say  that  what  is  tme  of  the  tmconBcioiu  in  the  ease 
of  this  girl  ie  true  of  the  unconedoua  generally. 


CONTENT  OP  UNCONSCIOUS         67 

The  hate  toward  the  mother  was  originally  the 
hate  of  jealousy;  the  little  girl  wished  the  mother 
out  of  the  way  in  order  to  have  her  father  all  to 
herself.  But  at  the  time  I  saw  the  patient  the 
father  had  long  been  dead,  and  there  was  no  pres- 
ent reason  why  the  daughter  shoidd  be  jealous  of 
her  mother.  Yet  the  old  infantile  jealousy  and 
hate  remained.  Thus  again  we  see  not  only  that 
the  processes  of  the  unconscious  are  uninfluenced 
by  reality  but  also  that  they  are  not  oriented  ac- 
cording to  time.  We  get  the  further  suggestion 
that  the  unconscious  is  infantile  and  that  it  has 
to  do  with  the  holophilio  impulses ;  and  that  there- 
fore its  content  is  in  large  measure  sexual. 

To  recapitulate  then  what  has  been  indicated  by 
this  case  (for  in  fact  it  gives  a  good  indication  of 
the  qualities  of  the  unconscious  in  general)  we 
may  say  that  the  unconscious  is  instinctive,  primi- 
tive, infantile  and  unoriented  as  to  time  and 
reality. 

Perhaps  it  may  not  be  entirely  clear  just  what 
is  meant  by  these  statements.    What,  for  in- 
stance, is  meant  when  we  say  the  unconscious  is 
instinctive  f 
I  say  to  a  man:    *^Have  you  asexual  instincts 
" Certainly, '^  he  replies.    **0f  course  I  have.'' 
^^But  how  do  you  know  thatf  "  I  ask. 
'^How  do  I  know  itf    How  can  I  help  knowing 
itf    If  I  see  a  pretty  ^rl,  I  want  to  kiss  her.    If 
I  fondle  her,  I  get  an  erection  and  desire  inter- 
course.   If  I  have  intercourse,  I  enjoy  it  and  for 
a  time  feel  satisfied.    And  if  I  do  not  have  it  at 
regular  intervals,  I  find  myself  thinking  of  sexual 


68    MORBID  FEAES  AND  COMPULSIONS 

things  and  craving  sexual  gratification  even 
though  I  might  will  to  do  otherwise." 

"Yes,*'  I  say,  *^but  what  of  the  instinct  itself? 
These  thoughts  and  feelings  and  actions  of  which 
you  speak  are  not  your  sexual  instinct.  The 
most  you  can  say  is  that  they  are  some  of  its  mani- 
festations. What  of  the  thing  itself?  Of  that 
you  say  nothing. 

^^  As  a  matter  of  fact,  have  you  not  accepted  the 
assumption  of  a  sexual  instinct  simply  as  a  way 
of  eicplaining  the  phenomena  you  describe,  very 
much  as  a  savage  explains  the  growing  of  a  tree 
or  the  flowing  of  a  river  by  assuming  that  a  spirit 
dwells  within  them?  Is  this  instinct,  as  far  as 
you  can  say,  anything  more  than  a  hypothesis? 
Have  you  ever  seen  it?  Or  touched  it,  heard  it 
or  smelt  it  ?  Have  you,  in  short,  any  direct  knowl- 
edge of  it,  any  more  than  the  savage  has  of  the 
spirit  he  believes  to  reside  in  the  tree?  Can 
you  know  of  it  in  any  other  way  than  inf  erentially, 
or  in  terms  of  its  manifestations?" 

**No,"  he  replies,  **you  are  right.  My  sexual 
instinct,  as  such,  never  is  and  never  can  be  an 
object  of  my  consciousness." 

Yet  though  we  cannot  have  direct  knowledge  of 
any  of  our  instincts  or  instinctive  tendencies,  we 
must  assume  their  existence,  just  as  we  assume 
the  existence  of  ether  waves  which  we  know  as 
light,  or  the  waves  of  air  which  we  know  as  sound. 
We  do  not  doubt  them  though  our  knowledge  of 
them  is  purely  inferential.  At  the  same  time  we 
recognize  that  what  to-day  we  call  instinct  may 
sometime  in  the  future  be  translated  by  science 


CONTENT  OP  UNCONSCIOUS         69 

into  terms  of  reflex  arcs  and  glands,  of  nervous 
impulse  and  tensions,  of  chemistry  and  electric- 
ity, just  as  we  replace  the  spirit  with  which  the 
savage  explains  the  flowing  of  a  river  by  another 
(and  equally  hypothetical)  something,  the  attrac- 
tion of  gravitation.  Of  the  reality  of  that  which 
we  call  instinct  and  of  the  reality  of  what  the 
savage  called  spirit  there  can  be  doubt.  There  is 
a  something  which  makes  the  tree  grow  or  impels 
us  to  sexual  actions.  Only  when  we  try  to  draw 
conclusions  as  to  the  nature  of  the  force  in  ques* 
tion  do  we  go  wrong. 

When  we  say  the  unconscious  is  instinctive  we 
mean  that  we  include  within  it  all  those  primal 
urges  and  impulses  which  we  must  assume  to  be- 
long to  the  nature  of  man,  to  be  inherent  rather 
than  acquired  from  education  or  environment,  but 
which  we  know  indirectly  only,  as  causes  inferred 
from  some  of  their  effects,  never  as  themselves. 

Likewise  we  say  the  unconscious  is  infantile,  be- 
cause of  certain  phenomena,  particularly  appar- 
ent in  abnormal  states,  which  we  must  infer  to  be 
effects  of  the  persistence  of  certain  urges  or  tend- 
encies which  are  normally  present  and  quite 
manifest  in  the  actions  of  the  child,  but  which  dis- 
appear under  the  refining  influences  of  education 
and  of  which  the  consciousness  of  the  adult  gives 
no  direct  information. 

We  say  further  that  the  unconscious  is,  in  large 
part,  psychic  material  that  has  been  repressed, 
for  we  assume  that  every  person  has  nearly  the 
same  heritage  of  instincts,  and  possesses  the  same 
infantile  tendencies*    Those  which  are  not  repre- 


/ 


70    MORBID  FEARS  AND  COMPULSIONS 

sented  in  his  consciousness  or  apparent  from  his 
behavior  we  do  not  assume  to  be  necessarily  non- 
existent but  rather  that  they  are  inhibited  and 
perfectly  controlled.  To  our  thinking,  then,  they 
exist  as  potential  rather  than  as  kinetic  forces, 
and  in  this  assumption  we  are  confirmed  by  the 
observation  that  in  certain  individuals,  in  whom 
they  are  the  least  apparent,  they  may  unexpect- 
edly some  day  become  manifest  under  the  guise  of 
neurotic  compulsions  or  other  psychopathological 
symptoms. 

Inasmuch  as  the  unconscious  is  largely  made  up 
of  instinctive  forces  or  of  infantile  tendencies 
which  behave  like  instincts,  the  statement  that  it 
is  not  oriented  with  regard  to  time  and  reality  is 
not  difficult  to  accept.  An  instinct  represents  a 
measure  of  energy  which  urges  toward  a  certain 
more  or  less  specific  type  of  action,  and  may  there- 
fore be  called  a  creator  of  tensions.  These  ten- 
sions remain  until  they  are  released  in  the  acts 
which  satisfy  the  instinct  or,  possibly,  dissolved 
by  some  change  within  the  organism.  Obviously 
these  tensions  occur  without  regard  for  time  or 
for  reality.  Thus  we  may  feel  hungry  irrespec- 
tive of  whether  or  not  it  is  the  logical  time  to  eat 
or  whether  eating  is  at  the  moment  convenient  or 
food  accessible.  The  inhibition  and  control  of 
the  instinctive  urge,  the  deferment  of  its  gratifica- 
tion according  to  the  demands  of  time  and  reality, 
belong  neither  to  anything  in  the  instinct  itself 
nor  to  anything  in  the  unconscious,  but  rather  to 
forces  of  the  f oreconscious  and  conscious  systems. 
In  the  unconscious  there  is  no  inhibition,  no  nega- 


CONTENT  OF  UNCONSCIOUS         71 

tioiii  no  conflict.  Its  energy  is  all  wish-energy, 
continuously  urging  and  pressing  for  outlet  like 
steam  within  a  boiler.  It  is  all  tension.  There 
are  no  counter-tensions,  a  phenomenon  which  oc- 
curs only  in  the  conscious  and  f  oreconscious  sys- 
tems.   ''The  unconscious  can  only  wish.'' 

We  have  said  that  the  unconscious,  as  far  as  its 
energic  content  is  concerned,  is  all  wish,  urge  or 
tension,  pushing  for  discharge.  All  inhibition, 
denial,  conflict,  control,  moral  or  esthetic;  all 
adaptation  to  the  demands  of  reason,  logic  and 
reality  come  not  from  the  unconscious  but  from 
the  higher  pyschic  systems,  consciousness  and  the 
foreconsdous,  especially  the  latter.  Thus  the 
f oreconscious  stands  like  a  screen,  to  use  Freud's 
metaphor,  between  the  unconscious  and  conscious- 
ness. It  controls,  directs,  inhibits  or  modifies  the 
energy  outflowing  from  the  unconscious,  decides 
the  eligibility  or  ineligibility  for  consciousness 
possessed  by  the  presentations  coming  from  the 
unconscious  and  admits  only  those  compatible 
with  its  trends  and  which  pass  its  censorship.  All 
people  are  practically  alike  in  the  content  of  the 
unconscious.  The  differences  between  people, 
between  personalities,  depend  upon  differences  in 
the  foreconscious.  For  in  the  foreconscious  re- 
side all  the  controlling  forces  derived  from  edu- 
cation, culture,  morality,  judgment  and  reason. 
The  unconscious  comprises  all  that  belongs  to 
primitive  man  and  to  the  child ;  the  foreconscious, 
that  belonging  to  civilization. 

I  believe  that  the  comparison  of  the  forecon- 
sdous to  a  screen  between  the  consdous  and  the 


72    MORBID  FEAES  AND  COMPULSIONS 

nnconscions  is  somewhat  unsuitable  because  of  its 
implication  that  the  foreconscious  is  passive. 
Really  the  foreconscious  is  active  and  in  other 
ways  than  merely  that  of  admitting  or  obstruct- 
ing presentations  that  press  forward  to  it  from 
the  unconscious.  Another  figure  perhaps  more 
appropriate  to  represent  the  psychic  processes  of 
the  foreconscious  would  be  that  which  compared  it 
to  the  managerial  staff  of  a  theater.  We  may 
compare  the  whole  mind  to  all  the  persons  in  a 
given  city  engaged,  or  desiring  to  engage,  in  the- 
atrical production,  whether  they  be  actors,  would- 
be  actors  or  those  constituting  the  machinery  of 
management.  The  persons  actually  occupying 
the  stage  at  any  given  instant  would  correspond 
to  a  moment  of  consciousness.  Like  our  thoughts, 
they  appear,  occupy  our  attention  for  a  limited 
time,  and  retire  to  be  succeeded  by  others,  or  to 
reappear  after  an  interval.  When  off  the  stage 
and  waiting  in  the  wings  for  their  cue  they  are 
like  thoughts  in  the  foreconscious,  latent  mem- 
ories, such  as  that  of  the  multiplication  table. 
They  are  not  dead  and  non-existent,  but  merely 
out  of  sight  for  the  time  being,  though  ready  and 
waiting  to  play  their  respective  parts  as  soon  as 
the  cue  is  given.  These  are  the  thought-processes 
passed  by  the  censor  and  eligible  for  conscious- 
ness but  not  actually  in  consciousness. 

To  the  unconscious  correspond  the  great  mass 
of  people  with  histrionic  aspirations  who  have  not 
theatrical  engagements.  It  is  from  this  horde 
that  those  actually  on  the  stage  originally  came 
and  to  it  some  of  them  will  at  length  return.   They 


CONTENT  OF  UNCONSCIOUS         73 

represent  the  primal  urge  toward  the  stage,  the 
force  back  of  it  which  makes  it  possible,  in  a  way 
its  fans  et  origo.  Those  actually  occupying  a 
place  before  the  audience  are  but  end-effects, 
epiphenomena  from  that  great  lift  and  urge  repre- 
sented by  the  whole  mass  of  the  theatrically  aspir- 
ant populace. 

As  our  conscious  thoughts  correspond  to  those 
persons  actually  playing  in  the  glare  of  the  foot- 
lights, and  the  unconscious  to  the  horde  of  as- 
pirants from  which  these  players  came,  the  fore- 
conscious  in  its  censoring  axstion  corresponds  to 
the  managerial  machinery  of  the  theater,  the  un- 
seen forces  which  sift  from  the  mass  of  aspir- 
ants those  worthy  to  play  a  part  upon  the  stage. 
Just  as  the  management  stands  between  those  who 
aspire  and  the  longed-for  place  upon  the  boards, 
the  foreconscious  stands  between  the  urge  and 
drive  of  the  unconscious  and  the  opportunity  for 
expression  in  the  lime-light  of  consciousness. 
The  actors  whom  we  see  and  the  thoughts  of 
which  we  are  conscious  are  thus  resultants  from 
the  action  of  two  systems  of  forces  both  of  which 
are  unseen,  the  one  being  a  lifting  force  which 
strives  for  expression,  the  other  a  sifting  force 
which  examines,  inhibits  and  directs,  and  allows 
expression  to  only  a  relatively  small  proportion 
of  the  aspirants  that  present  themselves  to  it. 

We  come  now  to  the  point  which  this  figure  was 
selected  to  emphasize.  The  action  of  the  fore- 
conscious  is  not  limited  to  merely  letting  through 
or  refusing  to  let  through  the  presentations  sub- 
mitted to  it.    Those  let  through  do  not  as  a  rule 


74    MORBID  FEAES  AND  COMPULSIONS 

enter  consciousness  in  exactly  their  original  f  ornL 
The  foreconscious  adds  something  to  them,  or 
forces  them  to  conform  to  qualities  of  its  content- 
Its  action  is  therefore  more  accurately  described 
by  comparing  it  to  the  mai;iagerial  system  of  the 
theater  than  to  a  screen  or  sieve.  Those  aspir- 
ants who  are  accepted  by  the  management  to  play 
parts  upon  the  stage  are  nx>t  ordinarily  free  to 
choose  their  parts.  The  would-be  Hamlet  may 
have  to  appear  as  a  coal  heaver ;  the  aspirant  for 
show-girl  honors  may  be  compelled  to  play  the 
part  of  a  hag.  So  it  is  with  the  relationship  be- 
tween the  foreconscious  and  the  unconscious.  An 
jS  unconscious  idea,  in  order  to  become  eligible  for 
consciousness  or  to  enter  consciousness  must  gain 
activation  from  the  foreconscious  system  in  addi- 
tion to  its  activation  from  the  unconscious  sys- 
tem. It  must  unite  with,  and  conform  to,  some- 
thing already  existing  in  the  foreconscious  sys- 
tem, or  else  remain  in  the  unconscious,  just  as  an 
actor  must  accept  tiie  role  provided  for  him  by 
the  theatrical  management  or  else  be  resigned  to 
remaining  unheard  and  unseen. 

The  foreconscious  system  not  only  determines 
the  admissibility  or  inadmissibility  of  ideas  to 
consciousness,  but  also  controls  the  outflow  of 
energy  toward  a  motor  discharge,  whether  to  the 
voluntary  system,  as  motility  (conduct  and  be- 
havior) or  to  the  involuntary  as  affectivity  (feel- 
ing, emotion).  If  those  excitations  or  tensions, 
belonging  to  the  unconscious  and  called  wishes, 
are  out  of  accord  with  the  trends  of  the  forecon- 
scious, they  are  denied  efferent  expression.    TJie 


^ 


PAILUEB  OF  BBPEESSION  75 

ideas  representing  them  are  not  admitted  to  con- 
sciousness; their  energic  quota  develop  no 
affects.^ 

(e)  Failure  of  Repression,  and  Descendants 

of  the  Repressed 

The  control  exercised  by  the  foreconscious  (re- 
pression) is  none  too  stable,  even  in  normal  per- 
sons. This  is  particularly  noticeable  in  respect  to 
discharge  into  affectivity.  Even  in  the  most  nor- 
mal, the  unconscious  at  times  forces  its  way  to 
emotional  expression  in  defiance  of  the  controlling 
tendencies.  The  periods  of  unreasonable  irrita- 
tion or  worry,  the  seemingly  inexplicable  preju- 
dices and  antipathies  and  the  transitory  feelings 
of  discouragement  and  depression  to  which  all 
healthy  people  are  at  times  subject  are  instances 
of  imperfect  control  by  the  foreconscious  over  the 
avenues  to  affective  outflow,  and  thus  represent 
slight  failures  of  repression. 

In  the  psychoneuroses  are  represented  the  more 
serious  failures  in  the  control  exercised  by  the 
foreconscious.  Tensions  and  wishes,  arising  in 
the  unconscious,  and  of  a  nature  really  incompat- 
ible with  the  trends  of  the  foreconscious,  force 
their  way  to  discharge  as  emotions  in  spite  of  its 
inhibiting  tendency,  and  become  manifest  as  neu- 
rotic symptoms.  Only  in  the  major  psychoses, 
however,  do  such  massive  failures  of  repression 

1  strictly  flpeaUng  there  are  no  unooiiBcious  affects^  the  affect 
being  a  fleneory  report  of  a  bodily  state.  See  Chapter  IV,  also  ef. 
Freud:  '1)aa  Unbewueste/'  To  epeak  of  unconsciouB  affects  (love, 
hate,  ete.),  ia  a  clinical  inaccuracy  so  cnrrent  as  to  be  Intimate. 


76    MOEBID  FEAES  AND  COMPULSIONS 

occur  as  to  allow  the  unconscious  free  access  to 
motility. 

The  purpose  of  repression,  as  we  said,  is  the 
avoidance  of  pain  or  of  the  development  of  pain- 
ful affects.  This  is  accomplished  by  withdrawing 
or  withholding  from  objectionable  ideas  any  fore- 
conscious  activation  and  by  maintaining  against 
them  a  counter-activation.  Bepressed  ideas  are 
thus  activated  only  by  the  energies  of  the  un- 
conscious system.  The  activation-energy  of  the 
unconscious  (and  generally  this  means  holophilio 
energy  or  libido)  can  never  of  itself  be  an  object 
of  consciousness.  The  libido-strivings,  or  as  we 
say,  *^ wishes,''  can  gain  representation  in  con- 
sciousness only  when  attached  to,  and  activating 
some  idea.  But  this  idea  must  be  of  a  kind  that 
will  be  passed  by  the  censor.  Otherwise  neither 
affectivity  nor  movement  is  developed  from  the 
unconscious  wish  or  striving,  no  matter  how  in- 
tense it  may  be. 

Though  the  idea  representing  or  activated  by 
an  unconscious  wish  is  rejected,  the  wish  may  in 
certain  circumstances  gain  representation  in  con- 
sciousness or  in  efferent  discharge  by  transferring 
itself  to  some  new  idea  which  is  not  inacceptable 
to  the  censor  nor  incompatible  with  the  trends  of 
the  f  oreconscious  or  with  the  specifications  of  the 
ego-ideal.  In  this  way  impulses  of  the  uncon- 
scious which  are  qualitatively  at  variance  with 
the  ruling  forces  of  the  personality  do  at  times 
evade  the  repression  by  hiding  behind  an  appar- 
ently unobjectionable  idea.    Thus  the  protective 


FAILUBE  OP  EEPBESSION  77 

purpose  of  repression  is  defeated,  for  repressed 
tensions  develop  affects,  or,  less  often,  produce 
action.  The  repression  is  in  part  a  failure  for  it 
keeps  unconscious  only  the  ideational  and  not  the 
energio  content  of  the  unconscious  presentation. 

This  matter  of  the  transfer  of  the  activating 
libido  from  a  rejected  idea  to  one  that  will  pass 
the  censor  can  perhaps  be  made  clearer  by  means 
of  a  concrete  example  from  a  case  where  it  has 
taken  place.  I  choose  one  with  which  we  already 
have  some  acquaintance,  namely  the  case  of  the 
young  woman  mentioned  in  the  early  part  of  this 
chapter  who  suffered  from  a  morbid  impulse  to 
take  medicine. 

This  drug-taking  compulsion  was  obviously  an 
example  of  an  effect  produced  by  unconscious 
forces,  for  the  young  woman  was  entirely  unable 
to  explain  what  its  motivation  was,  by  any  effort 
of  voluntary  introspection.  It  is  dear  that  the 
wish-energy  which  reached  her  consciousness  in 
the  shape  of  the  powerful  compulsion  to  take 
medicines  must  have  belonged  in  the  unconscious 
to  some  other  idea  than  that  of  taking  drugs,  but 
this  idea  we  should  suppose  was  repressed  by 
the  censor.  The  idea  of  taking  medicine,  against 
which  the  f  oreconscious  interposed  no  resistance, 
thus  played  the  part  of  a  substitute  for  the  first 
one  and  took  on  the  activating  libido  belonging  to 
it.^  The  energy  of  the  compulsion  thus  presum- 
ably belonged  to  some  wish  of  the  unconscious  in- 

1  Such  a  BubBtitute  idea  is  ordinarily  found  to  have  some  dose 
associative  connection  with  the  first  one. 


78    MORBID  FEARS  AND  COMPULSIONS 

compatible  with  the  trends  of  the  f  oreconscionsi  a 
wish  which  escaped  repression  only  by  means  of 
displacement. 

We  find  confirmation  for  these  theoretical  ex- 
pectations in  viewing  the  ascertained  facts  of  the 
case.  The  young  woman  in  question  was  a  de- 
vout Catholic.  To  be  a  good  Catholic  involves 
more  repression  than  is  required  of  the  adher- 
ents of  most  other  faiths.  This  girl  was  unmar- 
riedy  and  the  church  not  only  puts  a  strict  pro- 
hibition on  a  single  woman  doing  anything  of  a 
specifically  sexual  nature,  but  it  also  teaches  that 
thinking  sensual  things  and  entertaining  lifstful 
wishes  is  wrong  and  must  be  vigorously  combated. 
Thus  the  foreconscious  of  a  Catholic  girl  (assum- 
ing that  she  seriously  accepts  these  teachings) 
would  contain  strong  resistances  against  any 
ideasi  or  wishes  of  a  sensuously  erotic  character. 
Counter-activations  would  exist  against  such 
ideas ;  they  would  be  denied  activation  in  the  fore- 
conscious  or  the  consciouSi  and  their  activation 
which  is  derived  from  the  sex  impulse  and  from 
the  unconscious  would  be  likely  to  find  expression 
in  feeling  or  action  only  if  it  succeeded  in  attach- 
ing itself  to  some  apparently  non-sexual  ideas 
which  would  not  meet  with  counter-activations  or 
resistances. 

The  young  woman  of  whom  I  speak  was  in  most 
robust  physical  health,  and,  as  might  naturally  be 
expected,  had  an  equally  vigorous  sexual  impulse. 
She  had  a  strong  instinctive  (one  might  say  or- 
ganic) yearning  for  sexual  experience  and  to  bear 
children.    For  these  longings  no  legitimate  outlet 


1 


DESCENDANTS  OP  BEPRESSED      79 

was  provided,  since  she  was  not  married,  whUe 
her  conscience  and  reason  withheld  her  from  any 
actions  that  might  gratify  them  in  ill^timate 
ways.  In  addition  the  religions  and  family  teach* 
ings  incorporated  in  her  ego-ideal  and  in  the 
trends  of  the  f  oreconsdons  created  connter-acti- 
vations  and  resistances  against  her  admitting  to 
herself  the  whole  reality  of  these  wishes  or  in- 
dulging in  any  phantasies  corresponding  to  their 
fulfillment.  Had  her  repression,  in  accordance 
with  the  teachings  of  her  religion,  been  perfect 
(as  it  was  not),  practically  no  sensuously  erotic 
ideaer  would  have  been  allowed  access  to  her  con- 
sciousness and  no  affects  would  have  been  de- 
veloped from  her  sexual  longings. 

Complete  repression  of  such  powerful  forces  is 
by  no  means  easy  of  achievement  and  we  need  not 
be  surprised  that  this  patient  failed  to  accomplish 
it.  She  was  fairly  successful,  to  be  sure,  in  ex- 
cluding from  her  consciousness  the  ideas  corre- 
sponding to  her  sexual  wishes,  but  she  did  not  suc- 
ceed in  keeping  their  energy  confined  to  the  un- 
conscious. 

In  the  course  of  my  analytic  work  with  her  she 
at  length  recalled  that  as  a  little  child  she  had 
been  much  interested  in  the  question  of  where 
babies  come  from.  She  had  asked  her  parents 
to  answer  it  and  had  received  the  very  unsatisfy- 
ing statement  that  they  grew  on  trees  in  the  gar- 
den. Thereafter  she  pondered  the  question  in 
private  and  came  to  some  conclusions  of  her  own 
that  seemed  more  acceptable.  She  had  made  the 
observation  that  the  arrival  of  a  new  baby  in  the 


80    MOEBID  FEAES  AND  COMPULSIONS 

family  invariably  coincided  with  an  apparently 
severe  illness  on  the  part  of  her  mother.  She 
soon  conduded  that  a  causal  relation  existed  be- 
tween the  two  phenomena.  Then  arose  the  ques- 
tion as  to  what  caused  these  illnesses  of  her 
mother  which  gave  rise  to  such  remarkable  se- 
quelae. It  must  be,  she  at  length  decided,  that  her 
mother  made  herself  sick  by  means  of  some  drug 
or  medicine  obtained  from  the  doctor.  Little 
girls,  then,  if  they  only  knew  what  this  medicine 
was  and  could  get  some  of  it,  could  have  babies 
just  as  well  as  the  mother  and  would  not  have  to 
play  with  dolls. 

We  realize  at  this  point  what  was  the  meaning 
of  the  patient's  compulsion.  It  is  clear  that  in 
carrying  out  her  impulse  to  take  medicine  she  was 
acting  just  as  she  might  have  acted  in  her  child- 
hood if  she  had  been  desperately  anxious  to  have 
children.  At  the  time  of  her  childish  meditation 
she  never  did  decide  what  drug  the  doctor  gave 
her  mother,  and  thus,  as  far  as  she  knew,  any  drug 
might  have  been  the  one  to  produce  a  baby.  By 
virtue  of  her  infantile  sexual  theory  the  taking 
of  any  kind  of  medicine  could  be  a  symbolic  equiv- 
alent for  the  act  of  fertilization.  Though  an  in- 
nocent and  harmless  idea  in  itself,  it  served  to  rep- 
resent in  consciousness  the  libido  really  belong- 
ing to  the  idea  of  coitus  and  reproduction,— wishes, 
which,  because  of  her  moral  resistances,  were 
denied  either  free  entrance  to  her  consciousness 
or  discharge  as  feeling  or  action  of  obviously 
sexual  quality.  Now  that  we  know  from  what 
source  this  compulsion  derived  its  motive  power. 


DESCENDANTS  OP  KEPBESSED      81 

we  need  not  be  astonished  that  the  patient  was 
unable  to  resist  it. 

It  may  be  pointed  out  that  the  substitute  idea  of 
taking  drugs  not  only  bears  a  dose  associative  re- 
lation to  the  repressed  ideas,  but  also  that  it  must 
once  have  formed  a  part  of  the  same  sexual  com- 
plex which,  at  the  time  of  the  patient's  illness, 
was  subject  to  repression.  In  short  we  may  say 
that  it  was  a  descendant  of  the  repressed.  It 
should  here  be  mentioned  that  the  f oreconscious 
is  in  large  measure  made  up  of  what  in  one  sense 
must  be  regarded  as  descendants  of  the  repressed, 
and  thus  of  the  unconscious.  This  is  true  not  only 
of  ideas  and  memories  which  have  associative  con- 
nection with  unconscious  ones,  or  were  at  some 
time  a  part  of  the  repressed,  but  likewise  of  trends 
or  activations  some  of  which,  from  the  point  of 
view  of  function,  are  directly  opposite  to  the  re- 
pressed. Some  of  the  inhibiting  impulses,  some 
of  the  specifications  of  the  ego-ideal,  really  had  a 
common  origin  with  certain  trends  of  the  uncon- 
scious which  in  their  nature  would  be  regarded  as 
the  least  ideal  and  most  fully  deserving  of  re- 
pression. Bepressed  and  repressing  forces  in 
many  instances  really  developed  out  of  the  same 
primitive  instinctive  tendencies.  This  is  a  fact 
which  we  have  mentioned  in  Chapter  I  in  discuss- 
ing the  latency  period. 

I  have  brought  up  the  matter  of  f  oreconscious 
descendants  of  the  unconscious  in  order  at  this 
point  to  correct  the  impression  which  was  per- 
mitted to  be  made  in  the  early  part  of  Hhis  chap- 
ter, that  all  of  the  content  of  the  f  oreconscious  is 


82    MORBID  FEAES  AND  COMPULSIONS 

eligible  for  consdonsness  and  thus  within  the 
reach  of  voluntary  introspection.  Such,  as  a  mat- 
ter of  f  acty  is  not  the  case.  Though  a  large  part 
of  the  f  oreconscious  is  passed  by  the  censor  and 
thus  is  eligible  for  consciousness  and  within  the 
reach  of  introspection,  some  of  it,  represented  by 
certain  descendants  of  the  unconscious  cannot  be 
brought  into  consciousness  by  any  ordinary  in- 
trospective effort.  These  are  the  descendants  of 
the  repressed  which  possess  dose  associative  con- 
nection and  qualitative  similarity  with  it.  In  con- 
sequence of  their  quite  readUy  demonstrable  exist- 
ence in  the  f  oreconsdous  we  have  to  assume  a  sec- 
ond censor  which  stands  at  the  border  between  the 
f  oreconsdous  and  conscious  systems  just  as  the 
other  censor  stands  between  the  f  oreconsdous  and 
the  unconscious.  This  superficial  censor  operates 
against  certain  descendants  of  the  unconscious 
which  exist  in  the  f  oreconscious  but  which  bear 
the  dosest  association  with  the  unconscious  and 
with  the  original  repressed.  Whether  such  de- 
scendants are  rejected  by  the  superficial  censor  or 
whether  they  are  admitted  to  consciousness  not 
only  depends  on  their  quality  and  their  dose  asso- 
ciation with  the  unconscious  but  often  on  the  in- 
tensity of  their  activation.  Ideas  or  phantasies, 
which  through  their  content,  might  be  deemed  de- 
serving of  repression  may  be  admitted  to  con- 
sciousness provided  they  have  a  relatively  weak 
desire  content.  For  instance  a  married  woman 
may  not  object  to  being  attracted  by  a  man  not 
her  husband,  or  to  having  a  few  erotic  day  dreams 
about  him  as  long  as  she  feels  that  the  attraction 


*»■«• 


^XBX0P^ 


^^totiVA  ^88^e  teaistanee  vi^ 
€»^^.r  ^otda  that  1  ii»  •» 


»e  o*  r^g  gj^oTild  alBo  expect  tar.  w=  ^^^"^ 
»?'•  evetttedttie'WOidlw»««itt^  "-  *2* 
^*^e8B arose ivot 80 nndn^M*.  w.  ^'" 


86    MOEBID  FEABS  AND  COMPULSIONS 

inj  incident  from  my  seventh  year  which  appears 
to  have  heen  the  cause  of  my  forgetting  the  word 
PonA 

At  the  time  I  refer  to  I  had  a  dog  to  which  I 
was  greatly  attached.  My  brother  and  I  were 
playing  one  day  on  the  edge  of  a  small  pond  near 
our  house,  and  this  dog  was  in  the  water  swim- 
ming. We  began  to  throw  small  stones  into  the 
water  in  front  of  the  dog,  and  as  each  stone  struck 
the  surface  he  would  jump  for  the  splash,  try  to 
bite  ity  and  bark  in  joyous  excitement.  Finally, 
I  was  seized  with  the  malicious  desire  to  scare 
the  dog  and,  picking  up  a  stone  weighing  three  or. 
four  pounds,  I  threw  it,  intending  it  to  strike 
just  in  front  of  him  and  frighten  him  by  its  enor- 
mous splash.  Unfortunately,  my  aim  was  bad. 
The  big  stone  struck  the  dog  squarely  upon  the 
nose  and  stunned  him,  so  that  he  sank  beneath  the 
surface  and  was  drowned. 

My  grief  over  this  incident  was  without  ques- 
tion the  greatest  that  I  experienced  in  my  child- 
hood. For  days  I  was  utterly  inconsolable,  and 
for  a  long  time  there  were  frequent  occasions 
when  I  would  be  so  overcome  with  sorrow  and  re- 
morse as  40  cry  myself  to  sleep  at  night.  I  sup- 
pose, however,  that  my  grief  seemed  greater  than 
it  actually  was.  That  is  to  say,  it  was  exagger- 
ated to  serve  as  a  compensation  and  penance  for 
the  painful  perception  that  a  cruel  impulse  on 
my  part  was  responsible  for  the  dog's  untimely 
end. 

At  any  rate,  as  is  plain,  the  memory  of  the  in- 
cident was  a  very  painful  one,  and,  in  consequencei 


DESCENDANTS  OF  REPRESSED      87 

I  had  good  reason  to  wish  to  forget  not  only  the 
incident  itself  but  also  any  word  (such  as  Pond) 
which  might  serve  to  bring  it  before  my  conscious- 
ness. 

The  matter  to  which  I  wish  particularly  to  call 
attention  is  the  relevancy  of  my  seemingly  irrele- 
vant associations.  For  instance,  my  first  associa- 
tion— ^that  of  the  pitcheri  Dr.  Pond — contains 
three  ideas  connected  with  the  repressed  memory; 
viz«y  Doctor  (myself ),  Pond  (the  place  of  the  inci- 
dent),  and  pitcher  (one  who  throws).  My  second 
association— concerning  Indian  Pond  and  my 
throwing  into  the  water  the  big  stone  used  as 
anchor — ^is  equally  relevant.  Indian  Pond  is  in 
the  same  town  as  the  other  pond  in  which  the 
dog  was  drowned ;  my  memory  of  throwing  over- 
board the  anchor  is  connected  with  the  memory  of 
throwing  into  the  water  the  other  big  stone  which 
caused  the  dog's  death. 

The  association  pig  which  came  up  several  times 
in  the  latter  part  of  the  analysis  seems  at  first 
glance  to  have  no  connection  with  the  concealed 
memory.  A  connection  does  exist,  however.  The 
letters  P-I-G  reversed  are  G-I-P,  which  spells  the 
name  of  the  dog.  Thus  the  association  concern- 
ing the  pig-like  boy  and  the  mud  puddle — ^which 
contains  the  elements  P-I-G,  baseball  (t.  e.,  throw- 
ing) y  and  water— or  that  of  the  farmer  and  the 
pigs — P-LG,  death,  throwing,  and  water — ^is  seen 
to  be  perfectly  relevant.* 

Thus  it  may  readily  be  seen  that  every  idea  that 

iFrink — ^"Some  AnalysiB  in  the  Psychopathology  of  Everyday 
1M%"  Jounua  of  Abnormal  Ptyohology,  Vol.  XU,  No.  1,  1917. 


88    MOEBID  FEAES  AND  COMPULSIONS 

came  to  my  mind  was  in  some  way  associated  with 
the  repressed  memory,  either  directly,  as  are  those 
I  have  mentioned,  or  through  some  intermediate 
idea,  such  as  the  drowning  of  Ophelia,  which  con- 
nects Hamlet  and  the  quotation  therefrom  with 
the  drowning  of  the  dog. 

This  little  analysis  gives  a  miniature  view  of 
what  takes  place  in  analyzing  a  case  of  psycho- 
neurosis.  The  associations  the  patient  produces 
in  the  therapeutic  analysis  are  relevant  to,  and 
suggestive  of,  the  repressed  material  on  which 
the  symptoms  depend  just  as  in  this  analysis  all 
the  ^associations  bore  a  certain  similarity  to  the 
repressed  memory,  so  that,  even  if  it  had  not  come 
up  to  consciousness,  one  could  have,  from  these 
associations,  drawn  some  conclusions  as  to  its 
probable  content. 

Thus  we  may  close  this  chapter  with  the  state- 
ment that  our  knowledge  of  the  content  of  the  un- 
conscious is  derived  chiefly  from  the  study  of  the 
descendants  of  the  repressed  which  exist  in  the 
f  oreconscious  and  whidi,  by  abandoning  any  goal- 
idea  in  one's  thinking  and  resisting  the  action  o£ 
the  superficial  censoring  tendencies,  may  be  re- 
produced quite  freely  in  consciousness.^ 

1  The  repressed  painful  memory  which  caused  me  to  f org«t  the 
word  Pond,  though  an  entity  in  itself,  is  at  the  same  time  a  part 
of  a  larger  entity,  the  whole  sadistic  complex.  The  facility 
with  which  it  was  repressed  (I  do  not  suppose  I  had  thought  of 
it  in  many  years  until  I  attempted  to  analyze  my  forgetting) 
was  doubtless  in  part  dependent  upon  its  association  with  other 
repressed  material  belonging  to  this  complex. 


CHAPIJEB  m 

TWO  KINDS  07  THINKING,  AND  THB  PSYOHOLOQT  07 

THB  DBEAM 

IT  is  readily  apparent  upon  a  moment's  reflec- 
tion that  there  are  two  distinct  types  of  men- 
tal processes  going  on  in  our  minds,  and 
obeying  two  entirely  different  general  laws  or 
principles.  The  one  type  of  thinking,  which  is 
represented  in  its  most  highly  developed  form  by 
reasonings,  judgments  and  various  sorts  of  in- 
tellectual work,  takes  place  in  accordance  with 
what  Freud  calls  the  Beality  Principle.  The 
other,  most  familiarly  exemplified  by  day-dream- 
ing, is  governed  by  what  he  has  termed  the  Prin- 
ciple of  Pain  and  Pleasure,  or,  more  briefly,  the 
Pleasure  Principle. 

Thinking  of  the  first  mentioned  type,  or  Beality 
Thinking,  concerns  itself  mainly  with  actualities, 
with  the  answering  of  questions  and  the  solving 
of  problems,  and  serves  to  bring  us  into  closer 
touch  with  the  world  as  it  is,  and  to  assure  and 
perfect  our  adaptations  to  it.  Thinking  of  this 
type  is  for  the  most  part  done  in  words,  it  is  di- 
rected in  accordance  with  some  goal-idea,  and  it 
tends  to  produce  fatigue. 

The  second  type  of  thought  activity,  or  Pleas- 
ure Thinking  takes  place  in  pictures,  in  images 
rather  than  in  words.  It  is  not  directed  by  any 
goal-idea,  but  wanders  in  apparent  aimlessness 
from  one  theme  to  another,  and  does  not  tire  us. 

80 


90    MORBID  FEABS  AND  COMPULSIONS 

Its  only  concern  is  with  that  which  is  pleasant,  and 
instead  of  bringing  ns  into  closer  touch  with  real- 
ity,  tends  rather  to  withdraw  us  from  it,  particu- 
larly when  reality  is  unpleasant.  The  gain  or 
pleasure  in  this  type  of  thinking  comes  from  what 
is  thought  rather  than  from  the  result  of  thought, 
as  is  mainly  the  case  with  reality  thinking.  Beal- 
ity  thinking  seeks  to  achieve  the  fulfillment  of  our 
wishes  by  things  actual,  and  leads  to  the  making 
of  such  changes  in  the  external  world  as  are  re- 
quired for  that  result.  But  in  pleasure  thinking 
the  wishes  are  fulfilled  in  an  hallucinatory  man- 
ner, by  imagination,  and  in  total  disregard  of  time, 
space  and  reality.  Thus  no  amount  of  reality 
thinking  can  restore  the  past  or  awake  the  dead, 
yet  in  pleasure  thinking  I  can,  for  example,  be- 
come a  general  under  Alexander  the  Great,  fight 
in  his  armies,  hold  converse  with  him  or  for  that 
matter,  be  Alexander  himself ;  and  if  I  want  more 
worlds  to  conquer,  find  them  and  conquer  them, 
in  total  disregard  of  time  or  space  and  every  law 
of  nature.  Thus  in  day  dreaming  we  have  pleas- 
ure thinking  exemplified  in  its  most  familiar  form. 
In  a  measure,  though  not  accurately,  the  two 
types  of  thinking  correspond  to  the  differentiation 
of  the  unconscious  from  the  higher  psychic  sys* 
tems.  While  processes  of  the  pleasure  thinking 
type  may  occur  in  the  conscious  or  f  oreconscious 
systems,  reality  thinking  belongs  to  them  exclu- 
sively and  all  the  processes  of  the  unconscious  are 
of  the  pleasure  thinking  type.  This  is  in  accord 
with  the  statements  made  in  the  preceding  chap- 
ter to  the  effect  that  the  processes  of  the  Unoon- 


PLEASXJEE  THINKING  91 

BoioaB  are  imoriented  with  regard  to  time,  space 
and  external  reality,  and  that  the  Unconsoioos 
can  only  wish. 

Obviously  those  processes  governed  solely  by 
the  pain  and  pleasure  principle  and  disregarding 
reality  are  the  more  prinaitive  and  the  older  in 
the  history  of  the  mind.  They  correspond  to  phy- 
logenetic  and  ontogenetic  phases  antedating  the 
use  of  words,  but  in  a  sense  are  even  more  primi- 
tive than  is  implied  by  that  statement  One  can 
conceive  of  a  period  in  the  history  of  the  psychic 
apparatus  when  they  were  the  only  type  of  mental 
process. 

Against  this  assumption  the  objection  of  course 
arises  that  an  organism  which  merely  hallucinates 
its  inner  needs  and  disregards  reality  could  not 
maintain  itself  for  even  a  short  time  and  hence 
never  could  have  existed  save  as  a  fiction.  But 
the  employment  of  such  a  fiction  is,  as  Freud  ex- 
plains, justified  by  the  observation  that  the  suck- 
ling infant  almost  realizes  such  a  state  of  aflfairs 
through  the  aid  of  the  nursing  by  the  mother. 
''He  apparently  hallucinates  the  fulfillment  of 
his  innermost  needs,  displaying  meanwhile 
through  the  motor  dis<diarge  of  crying  and  kick- 
ing, the  displeasure  arising  through  the  increas- 
ing tension  and  failed  satisfaction,  and  thereupon 
he  experiences  the  satisfaction  hallucinated.^ 
Only  later  does  he  learn  to  use  these  discharge 
expressions  purposely  as  a  means  of  communi- 
cation.''   At  first  he  hhs  no  appreciation  of  what 

1 '^ Jahrlmeli   fOr   Pi^yielioaaalytische   iind   PBychopathologiflche 
Yonohtiiigai,''  Bd.  lU,  HH  I,  1912. 


92  MOEBH)  FEAES  AND  COMPULSIONS 

intervenes  between  a  wish  and  its  fulfillment ;  for 
anything  he  may  sense  to  the  contrary  a  wish  ful- 
fills ijtself  «  His  crying,  eta,  is  at  first  simply  an 
epiphenomenon  of  unsatisfied  wish-tensions ;  that 
it  informs  another  person  of  his  desires  and  that 
the  satisfaction  shortly  experienced  comes  only 
throng  the  instromentality  of  another  being  he 
does  not  at  first  know. 

The  attempt  to  realize  all  satisfactions  by  the 
hallucinatory  method  is  abandoned  with  the  first 
disappointments.  The  psychic  apparatus  is  com- 
pelled to  image  what  is  actual,  not  simply  what  is 
wished  for ;  it  must  depict  the  real,  even  if  reality 
be  unpleasant,  and  must  strive  for  real  changes, 
not  simply  imaginary  ones.  From  these  necessi- 
ties reality  thinking,  so  important  in  its  results, 
begins. 

In  his  paper  FormuUeriing  uher  die  zw^ 
Primipien  des  Psychischen  Geschehens,^  Freud 
gives  a  schematic  outline  of  the  development  of 
the  psychic  functions  a  portion  of  which  is  some- 
what as  follows.  The  progressively  increasing 
significance  of  external  reality  which  begins  as 
soon  as  the  purely  hallucinatory  method  of  wish 
fulfillment  commences  to  decline,  correspondingly 
increases  the  significance  of  the  sense  organs  re- 
ceiving impressions  from  the  external  world  and 
of  that  part  of  consciousness  connected  with  them. 
The  individual  now  becomes  interested  in  sense 
qualities  in  addition  to  the  qualities  of  pain  and 
pleasure  with  which  he  was  exclusively  concerned 

i^'Jahrbuch   filr   FBychoanalytisclie  und   Psychopathologische 
IV>rgchungen/'  Bd.  lU,  Hit  I,  1912. 


EEALITT  THINKING  93 

at  first.  A  special  function,  that  of  attention,  is 
then  arranged  which  examines  the  external  world 
in  order  that  data  concerning  it  may  be  on  hand 
at  any  time  an  urgent  need  arises.  Instead  of 
merely  waiting  for  the  coming  of  sense  impress- 
ions, this  activity  goes  out  to  meet  them.  At  the 
same  time  a  system  of  records  is  devised  in  which 
the  results  of  this  examination  are  preserved  and 
which  constitutes  a  part  of  what  we  call  the 
memory. 

Instead  of  repressing  everything  painful,  in- 
stead of  denying  activation  to  all  those  presenta- 
tions tending  to  create  displeasure,  of  ignoring 
everything  unwished  for,  the  psychic  apparatus 
begins  to  exercise  the  function  of  judgment  which 
seeks  to  decide  whether  the  incoming  presenta- 
tions are  true  or  false,  that  is  to  say  in  harmony 
with  reality,  accepting  that  which  so  harmonizes 
even  if  it  be  unpleasant,  and  determining  what 
shall  be  accepted  as  true  by  comparing  the  pre- 
sentations in  question  with  the  memory  records 
of  reality. 

The  motor  discharges  which  during  the  reign 
of  the  pleasure  principle  simply  served  the  func- 
tion of  relieving  the  apparatus  from  the  tensions 
produced  by  incoming  stimuli,  by  draining  off 
these  tensions  as  affective  phenomena,  motor  rest- 
lessness, etc.,  now  become  employed  in  a  new  func- 
tion, that  of  producing  desirable  changes  in  the 
external  world.  They  now  become  purposeful 
actions,  the  forerunners  of  work. 

The  stimulus  no  longer  results  inunediately  in  a 
complete  motor  discharge.    Between  the  receipt 


94    MORBID  FEABS  AND  COMPULSIONS 

of  the  stinmlus  and  the  motor  disoharge  as  ac- 
tion now  intervenes  the  process  of  thinking  whidi 
was  originally  represented  hy,  and  is  formed  from, 
the  aot  of  imaging.  Originally  thinking  as  a 
process  distinct  from  mere  imaging,  and  applied 
to  the  relations  between  impressions  of  objects, 
was  probably  nnoonscions.  Only  throngh  con- 
nections with  verbal  residues  does  it  gain  such 
qualities  as  render  it  perceptible  to  consciousness. 
The  psychic  apparatus  learns  to  tolerate  the 
greater  degrees  of  tension  necessitated  through 
the  deferment  of  motor  discharge,  and  thinking, 
that  is  to  say  reality  thinking,  really  represents  a 
sort  of  experimental  paying  out  of  these  accumu- 
lated tensions  in  small  quantities. 

While  those  processes  dominated  exclusively  by 
the  pleasure  principle  represent  nothing  but  wish, 
and  strive  for  nothing  but  the  securing  of  imme- 
diate pleasure  or  the  avoidance  of  immediate  pain, 
the  goal  of  reality  thinking  is  essentially  that  of 
utility.  Thus  the  replacement  of  the  pleasure 
principle  by  reality  thinking  in  the  consciousness 
of  the  individual  is  never  complete,  as  we  know. 
From  the  beginning  of  the  influence  of  the  reality 
principle  in  the  mental  life  there  remains  split  off 
a  certain  amount  of  thought  activity  dominated  by 
the  old  laws  and  absolved  from  being  tested  or 
evaluated  in  accordance  with  the  impressions  of 
reality.  It  is  represented  in  the  play  and  '^make 
believes"  of  children  and  by  the  phantasies  and 
day  dreams  of  the  adult,  where  real  objects  are 
dispensed  with  throughout.  The  processes  of  the 
unconscious  remain  always  under  the  domination 


PLEASURE  THINKING  95 

of  the  old  principle  of  pleasure.    It  is  the  only 

law  they  know,  and  of  this  fact,  we  shall,  in  the 

following  pages  meet  with  numerous  examples.^ 

The  general  tendency  to  satisfy  with  pictures 

1  *Th»  relMM  fram  the  principle  of  pleaaure  by  meant  of  the 
reality  principle^  with  the  psychical  reenlta  whidi  proceed  from 
it  (the  release)  which  here  in  a  aehematic  exposition  is  restricted 
to  a  single  propoaition,  really  is  completed  neither  at  once  nor 
simultaneously  on  the  whole  line.  But  while  this  dsTelopment 
takes  place  in  the  ego-impulses,  the  sexual  impulses  are  released 
from  it  in  a  Tery  significant  manner.  The  sexual  impulses  at  first 
behave  autoerotically;  they  find  their  satisfaction  in  the  individu* 
al's  own  body,  and  do  not  reach  the  situation  of  denial  which  com- 
pelled the  installation  of  the  reality  principle.  When  later  the 
individual  begins  the  process  of  finding  an  object,  he  waits  a  long 
time  because  of  the  period  of  latency,  which  prolongs  the  sexual 
development  up  to  the  time  of  puberty.  These  two  element*— 
autoerotism  and  the  period  of  latency— have  the  result  that  the 
sexual  impulse  is  retarded  in  its  psychic  development  and  remains 
a  great  deal  longer  under  the  dominance  of  the  pleasure  prind* 
pie,  from  which  many  persons  can  never  free  themselves. 

''Because  of  these  relations  there  is  a  closer  connection  between 
sexual  impulse  and  phantasying  on  the  one  hand  and  the  ego- 
impulses  and  the  activities  of  consciousness  on  the  other.  We 
find  this  connection,  in  normal  persona  as  well  as  in  neurotics, 
a  very  intimate  one^  although,  by  means  of  these  considerations 
from  genetic  psychology,  it  is  recognized  as  a  MOOfidafy  one. 
The  continually  operating  autoerotism  makes  it  possible  that  the 
easier  momentary  and  phantastic  satisfaction  on  the  sexual  object 
is  retained  so  long  in  the  place  of  the  real  one  which  however 
requires  trouble  and  delay.  In  the  realm  of  phantasy  repression 
remains  all-powerful.  It  makes  possible  the  inhibition  of  ideas 
(Vorstellungen)  in  Miaiu  na§e€mdi  before  they  can  enter  con- 
sciousness, if  their  activation  can  occasion  a  release  of  pain.  This 
is  the  weak  spot  of  our  psychic  organisation,  which  may  be  em- 
ployed to  bring  under  the  dominance  of  the  pleasure  principle 
again  those  thought  processes  which  have  already  become  rational. 
An  essential  bit  of  the  psychic  disposition  toward  neurosis  is 
accordingly  produeed  by  the  delayed  education  of  the  sexual  im- 
pulse to  regard  reality  through  the  conditions  which  render  pos- 
siUe  this  delay.**— F^eud,  Lo. 


96    MOBBID  FEARS  AND  COMPULSIONS 

of  the  imagination  (images  jof  any  dense  quality) 
the  desires  that  reality  leaves  nngratified,  as  most 
familiarly  exemplified  in  our  day  dreams  is  not 
limited  in  its  operation  to  our  waking  hours.  The 
tensions  represented  by  various  ungratified  wishes 
of  the  day  persist  in  some  measure  after  we  go  to 
sleep  and,  if  of  sufficient  intensity,  serve  to  dis- 
turb our  rest.  Then  pleasure  thinking  comes  to 
our  aid  and,  as  in  the  suckling  period,  an  attempt 
is  made  to  still  and  satisfy  these  longings  by  the 
hallucinatory  route — ^by  pictures  of  the  imagina- 
tion— and  upon  awakmg  we  say  that  we  have 
dreamed. 

In  short,  the  night  dream  and  the  day  dream  are 
really  analogous.  We  may  define  either  one  as 
the  imaginary  ftUfillment  of  a  wish.  Neverthe- 
less, the  truth  of  this  statement  is  by  no  means 
self-evident.  That  the  day  dream  is  a  phantasied 
wish-fulfillment  is  perfectly  obvious.  But  that 
the  night  dream  invariably  fulfills  a  wish  seems 
on  first  thought  impossible.  Over  fifty  per  cent, 
of  dreams  seem  to  the  dreamer  distinctly  dis- 
agreeable, while  many  others,  though  not  actively 
unpleasant,  nevertheless  apparently  fail  to  rep- 
resent anything  for  which  a  sane  person  might 
be  supposed  to  wish. 

Yet  the  apparent  unlikeness  between  the  night 
dream  and  the  day  dream  is  not  due  to  any  lapse 
of  the  principle  of  wish  fulfillment  but  rather  to 
a  difference  in  the  way  the  desired  things  are  rep- 
resented. The  representation  in  the  day  dream 
is  direct;  the  thing  or  occurrence  desired  is  pic- 
tured as  actual  and  present  without  any  ambigu- 


•  * 


w '    ->    rf 


J  •  •  J  • 


<<    «       V    « 


OetirUty  tf  th4  Ntte   Sorlt   TrOnn 


NIGHT  DBEAMS  97 

ity  or  vagaeness.  But  in  the  night  dream  the  rep- 
resentation is  indirect.  What  is  desired,  instead 
of  being  pictured  in  its  true  f  orm,  is  represented 
by  implications,  innuendoes,  symbols,  allegorical 
figures,  etc.  Thus  while  the  day  dream  may  be 
taken  more  or  less  at  its  face  value,  the  meaning 
of  the  night  dream  is  not  to  be  found  on  its  sur* 
face.  The  night  dream,  like  a  rebus  or  an  alle- 
gory, has  to  be  interpreted  if  we  wish  to  know  its 
meaning.  Only  in  this  way  can  we  learn  what 
wish  it  fulfills.  That  our  night  dreams  seem  to 
be  senseless  and  absurd  is  not  due  to  their  actually 
lacking  meaning  but  for  the  most  part  to  the  fact 
that  indirect  rather  than  direct  representation  has 
been  employed. 

In  order  to  make  perfectly  clear  the  diJQFerence 
between  direct  and  indirect  representation,  and 
how  readily  an  appearance  of  absurdity  is  created 
by  the  use  of  the  latter,  I  will  introduce  an  ex- 
ample of  indirect  representation  in  the  shape  of 
the  picture.  Figure  1. 

This  is  a  copy  of  a  cartoon  which  appeared  in 
the  New  York  Tribune,  March  6th,  1916,  just 
after  Mr.  Bryan  had  made  a  trip  to  Washington, 
ostensibly  in  the  interests  of  pacifism.  It  ex- 
presses tbe  artist's  opinion  that  this  trip  did  not 
spring  from  entirely  altruistic  motives — ^that,  in 
figurative  language,  the  Great  Commoner,  in  ap- 
pearing in  the  role  of  the  dove  of  peace,  really 
had  an  ax  to  grind. 

A  direct  expression  of  the  ideas  represented  by 
the  cartoon  would  be  the  simple  statement  that 
Mr.  Bryan's  visit  to  Washington  was  primarily 


98    MORBID  FEARS  AND  COMPULSIONS 

intended  not  so  much  to  farther  the  interests  of 
pacifism  as  those  of  Mr.  Bryan  himself.  But  the 
cartoon,  which  expresses  the  same  thought  in  an 
indirect  manner,  if  taken  merely  at  its  face  value 
would  seem  to  refer  to  something  entirely  differ- 
ent If,  for  instance  we  were  in  the  position  of  an 
Icelander,  and  unfamiliar  with  American  politics 
and  the  figures  of  English  speech,  the  cartoon 
would  seem  just  as  senseless,  bizarre  and  fantastic 
as  do  most  of  our  dreams,  and  precisely  for  the 
same  reason,  for  it  would  then  be  a  case  of  indi- 
rect representation  which  we  had  not  interpreted. 
To  us  the  cartoon  has  a  meaning  only  because  of 
our  ability  to  interpret  it.  To  be  able  to  make 
the  interpretation  we  need  to  possess  certain  in- 
formation which  is  not  given  by  the  cartoon  itself. 
Thus  we  have  to  know  the  setting— what  was  go- 
ing on  in  the  political  world  at  the  time  the  cartoon 
was  drawn.  We  must  be  able  to  recognize  the 
features  of  Mr.  Bryan,  and  must  be  familiar  with 
the  symbolic  figure,  the  dove  of  peace,  and  the  col- 
loquialism ''to  have  an  ax  to  grind."  If  we  do 
not  have  this  information  we  can  take  the  cartoon 
only  at  its  face  value  and  then  it  seems  utterly 
senseless.  What  is  true  of  indirect  representa- 
tion as  exemplified  in  this  cartoon  also  applies 
everywhere  else.  In  order  to  see  any  sense  or 
meaning  in  it,  one  has  to  have  certain  informa- 
tion not  given  in  the  representation  itself,  and  to 
use  this  as  a  means  of  interpretation.  When  we 
have  the  required  information  and  use  it,  the  ap- 
pearance of  senselessness  vanishes  at  once. 
I  will  now  relate  a  real  dream  and  I  think  it 


NIGHT  DREAMS  99 

will  be  apparent  that  the  means  by  which  ideas  are 
represented  in  it  are  almost  identical  with  those 
of  the  cartoon.  To  see  what  it  means,  the  same 
sort  of  extra  information  and  interpretation  is 
required  as  in  the  case  of  the  cartoon,  and,  when 
the  interpretation  is  made,  what  seemed  nonsense 
suddenly  appears  as  sense. 

An  acquaintance  of  mine  once  dreamed  that  he 
was  kicking  a  skunk  but  that  animal,  instead  of 
emitting  its  usual  odor,  gave  off  a  strong  smell 
of  Palmer's  perfume. 

This  dream  of  course  seems  absolutely  absurd 
and  meaningless.  But  we  must  remember  that 
as  yet  we  know  nothing  of  the  dreamer,  nor  of  the 
setting  in  which  the  dream  occurred.  In  short 
we  are  in  about  the  same  position  as  would  be  an 
Icelander  in  attempting  to  interpret  the  cartoon. 
When,  however,  the  setting  is  known  the  dream 
is  not  at  all  difficult  to  interpret. 

In  discussing  his  dream  with  me  the  dreamer, 
whom  we  may  call  Taylor,  was  reminded  by  the 
idea  of  Palmer's  perfume  that  he  had  been  em- 
ployed as  derk  in  a  drug  store  at  the  time  the 
dream  occurred.  This  brought  to  his  mind  the 
following  episode  which,  as  will  readily  be  seen, 
was  what  gave  rise  to  the  dream. 

There  had  come  to  the  drug  store  one  day  a 
man  who  demanded  ten  cents'  worth  of  oil  of 
wormseed  (Chenopodium),  and,  as  this  drug  is 
not  classed  as  a  poison,  Taylor  sold  it  to  him  with- 
out asking  him  any  questions.  The  man  then 
went  home  and  administered  a  teaspoonful  of  the 
oil  to  his  six  months  baby.    The  child  vomited  the 


100    MOEBID  PEAES  AND  COMPULSIONS 

first  do86y  a  second  was  given  and  thereupon  tlie 
child  died.  Then,  instead  of  taking  the  responsi- 
bility npon  his  own  shoulders,  the  father  sought 
to  blame  Taylor  for  the  child's  death.  The  town 
in  which  the  occorrence  took  place  was  a  small 
one  and  in  a  day  or  so  most  of  the  inhabitants  had 
heard  his  very  untrue  account  of  the  affair.  Then 
Taylor,  who  was  naturally  very  unwilling  to  be 
thus  exposed  to  public  censure,  sought  to  defend 
himself  by  setting  forth  his  version  of  the  matter 
to  every  customer  that  entered  the  drug  store.  In 
a  few  days  the  proprietor,  annoyed  by  this  con- 
stant reiteration,  said  to  him:  ^^Look  here,  Tay- 
lor, I  want  you  to  stop  talking  about  this  affair. 
It  does  no  good.  The  more  you  kick  a  skunk,  the 
worse  it  stinks." 

That  night  Taylor  had  the  dream  I  have  related. 
It  is  not  difficult  to  see  why  it  occurred  and  what 
it  meant.  By  the  proprietor's  command  Taylor 
had  been  robbed  of  the  only  means  at  his  disposal 
for  squaring  himself  with  the  public,  and  in  con- 
sequence he  went  to  bed  that  night  very  much 
worried  and  disturbed.  Though  he  dropped  off  to 
sleep,  these  tensions  persisted  sufficiently  to  dis- 
turb his  rest.  He  therefore  dreams  that  he  is 
still  kicking  the  skunk  but  without  any  unpleasant 
results,  for  it  has  a  sweet  smell  instead  of  an 
evil  one.  In  other  words  the  meaning  of  the 
dream  is  that  he  continued  to  defend  himself  and 
that  good  rather  than  ill  came  of  it.  The  way 
these  thoughts  are  expressed  in  the  dream  is  ob- 
viously almost  identical  with  that  employed  by 
the  artist  in  the  cartoon.    For  instance  the  dream 


WW  •      w        w        - 

,  *  -  *  «    •  J 


«     • 


J  -     ■*  •  -  •  w' 


t       •  «»w*w« 


•f      J  J  • 


^       -J      ^ 


'   <7(>uVte(v   0/   th4   Sea    lark    TImu 


NIGHT  DREAMS  t.i'---    101 

uses  the  proverb  of  the  proprietor  in  just  the 
same  manner  that  the  artist  employed  the  phrase 
**to  have  an  ax  to  grind/'  One  might  easily 
imagine  a  cartoonist  for  the  local  paper  in  Tay- 
lor's town  (if  all  the  circumstances  were  known 
to  the  public)  drawing  a  cartoon  with  the  title 
**What  Taylor  would  like  to  do''  which  would 
be  identical  with  the  dream. 

We  may  now  consider  another  instance  of  in- 
direct representation  as  exemplified  by  the  news- 
paper cartoon.  (Fig,  2.)  We  behold  a  picture 
of  a  man  who,  judging  from  the  armor  he  wears, 
would  seem  to  belong  to  the  time  of  Julius  Caesar. 
Nevertheless,  he  stands  near  a  very  modem  lamp 
post  on  a  curb  of  what  one  would  suppose  to  be 
Sprang  Street.  He  holds  in  one  hand  a  watch 
of  remarkable  size  and  in  the  other  a  bouquet  ap- 
parently composed  of  flowers  and  bayonets.  In 
short  the  picture  gives  about  the  same  impression 
of  fantastic  absurdity  as  do  most  of  our  dreams, 
and  like  a  dream  it  requires  interpretation. 

This  cartoon  is  not,  however,  as  easy  to  inter- 
pret as  was  the  first  one.  In  fact,  as  it  stands,  it 
absolutely  defies  interpretation.  We  assume  that 
indirect  representation,  some  sort  of  symbolism, 
was  used  in  forming  it,  but  in  order  to  interpret  it 
we  must  know  the  meaning  of  these  symbols  and 
something  of  the  setting  or  of  what  the  artist  had 
in  mind  when  he  drew  the  picture.  As  we  look  at 
the  picture  now,  we  are  just  as  ignorant  of  the 
meaning  of  its  symbols  as  we  are  of  the  dream 
symbols  of  another  person. 


•Ma-MOBBlIi  FE^  AND  COMPULSIONS 

This  picture  appeared  in  the  New  York  Times 
in  the  spring  of  1915,  with  the  title  ^^This  is  the 
Place,  but  Where's  the  Oirlt"  In  the  original 
the  symbols  employed  by  the  artist  were  labeled. 
On  the  sheet  of  paper  which  lies  on  the  sidewalk  in 
front  of  the  man  was  inscribed  the  phrase  '^  Italy 
to  go  to  war  in  the  Spring"  and  the  tag  attached 
to  the  bouquet  he  carried  bore  the  words  '^For 
Miss  Italy.''  At  the  time  the  picture  was  pub- 
lished, Italy,  in  spite  of  numerous  predictions,  had 
not  yet  joined  in  the  European  war. 

By  the  aid  of  these  hints  the  picture  is  very 
readily  interpreted.  The  meaning  is  something 
like  this :  ''Italy  is  behaving  like  a  fickle  girL  No 
reliance  can  be  placed  upon  her. "  The  artist  has 
used  as  symbols  a  man,  a  bouquet  and  a  lamp  post 
to  express  a  thought  about  something  entirely 
different,  namely  the  attitude  of  that  country  to- 
ward the  great  conflict. 

In  this  cartoon,  as  in  the  first  one,  the  same 
method  of  indirect  representation  is  employed 
that  is  used  in  dreams,  with  one  difference  how- 
ever. The  artist  has  labeled  his  symbols.  The 
symbols  in  the  dream  are  not  labeled  as  they  were 
in  the  original  of  this  picture.  The  dream  is  like 
the  picture  as  I  have  displayed  it — ^that  is,  with- 
out the  hints  to  interpretation  that  appeared  in 
the  original.  Hence  if  we  wish  to  interpret  a 
dream  we  must  get  the  dreamer  to  label  his  sym- 
bols in  the  waking  state  and  after  the  dream  is 
finished.  This  is  accomplished  by  the  ''method 
of  free  association"  with  which  we  already  have 
some  slight  acquaintance  from  the  analysis  of  my 


NIGHT  DREAMS  103 

forgetting  of  the  word  Pond.  The  dreamer  is 
asked  to  fix  his  mind  upon  each  part  of  the  dream 
in  turn  and  to  relate,  without  exerting  any  critique, 
all  his  incoming  thoughts.  For,  as  wUl  be  ex- 
plained shortly,  the  dream  is  really  a  product  of 
the  unconscious  and  of  the  repressed,  and  we 
learn  what  it  means  by  getting  the  dreamer  to  re- 
produce by  free  association  various  descendants 
of  the  unconscious.  These  descendants,  or  asso- 
ciations, play  in  dream  analysis  about  the  same 
role  as  the  words  the  aiAist  painted  in  his  cartoon ; 
they  represent  labels  for  the  dream  symbols.  By 
means  of  them  we  may  learn  of  the  hidden  mean- 
ing of  the  dreauL^ 

The  following  simple  examples  in  the  form  of 
parts  of  two  dreams  show  anew  the  way  thoughts 
are  expressed  through  indirect  representation, 
and  also  the  relation  of  the  free  associations  to 
the  thoughts  represented,  or  in  other  words  how 
dream  symbols  may  be  labeled. 

A  woman  received  a  visit  from  one  of  her  old 
lovers  who  now  lives  in  Massachusetts.  A  few 
nights  later  she  had  a  dream  in  which  she  found 
herself  standing  in  an  open  window.  The  grass 
all  about  her  was  of  a  very  fresh  brilliant  green. 
Close  by  was  a  tiny  stream  of  water  which  seemed 
to  have  its  source  at  the  base  of  a  rocky  ledge  a 
short  distance  away. 

1  It  may  be  remarked  at  this  point  that  not  much  can  be  ac- 
complished unless  there  exists  a  certain  trust  or  rapport  on  the 
part  of  the  dreamer  toward  the  person  analyzing  his  dream. 
Without  this,  so  much  censorship  is  exercised  over  the  incoming 
thoughts  that  the  reproduced  associations  are  superficial  and  it 
is  difficult  to  deduce  much  from  them. 


106    MORBID  FEARS  AND  COMPULSIONS 

responds  to  the  actual  title  of  the  book  in  the  news- 
paper contest.  This  part  is  known  as  the  latent 
dream  content.  It  is  not  the  manifest  but  the 
latent  content  of  the  dream  which  in  each  dream 
corresponds  to  the  thing  or  occurrence  wished  for. 
The  manifest  content  simply  represents  what  is 
wished  for,  in  the  same  way  that  the  pictures  in 
the  newspaper  represented  the  title  of  some  book 
but  were  not  the  actual  title. 

This  distinction  between  the  manifest  and  the 
latent  content  of  the  dream  has  been  repeatedly 
emphasized  by  all  psychoanalytic  writers,  but 
their  readers  with  almost  unbelievable  regularity 
have  failed  to  comprehend  and  appreciate  it. 
Again  and  again  one  hears  the  objection  that  the 
dream  cannot  represent  a  wish  fulfillment  because 
all  people  have  unpleasant  dreams.  Such  an  ob- 
jection is  possibly  only  through  misunderstanding. 
The  manifest  content  is  not  what  is  wished  for 
any  more  than  the  United  States  Ambassador  to 
England  is  the  United  States.  The  manifest  con- 
tent, like  an  ambassador,  merely  represents  some- 
thing, and  what  fulfills  the  wish  is  not  the  repre- 
sentative but  the  thing  represented.  The  fact, 
then,  that  the  manifest  content  or  representative 
may  appear  unpleasant  does  not  imply  that  the 
thoughts  represented  must  be  unpleasant. 

In  the  clinical  chapters  of  this  book  we  shall  be- 
come acquainted  with  dreams  which,  from  the 
point  of  view  of  the  manifest  content,  were  very 
unpleasant  but  which  were  revealed  upon  analysis 
to  represent  wish  fulfillments,  nevertheless  (e.  g. 
the  case  of  Miss  Sunderland,  pages  451,  452). 


DISTORTION  107 

Through  what  has  been  brought  out  by  the 
examples  of  dreams  already  given,  we  are  now  pre- 
pared for  the  statement  that  while  the  night  dream 
and  the  day  dream  are  both  phenomena  of  pleas- 
ure thinking  and  both  represent  an  effort  to  attain 
satisfaction  by  the  old  hallucinatory  route,  the 
night  dream  ordinarily  differs  from  the  day  dream 
in  that  its  wish  fulfillment  is  disguised.  The  ex- 
planation of  this  fact  takes  us  to  a  point  with 
which  we  are  already  familiar,  namely,  the  inhib- 
iting power  and  censoring  influence  exerted  by  the 
foreconscious  over  wishes  and  ideas  coming  from 
the  Unconscious.  The  chief  reason  why  the  hallu- 
cinated wish  fulfillment  in  the  night  dream  occurs 
as  an  indirect  and  distorted  presentation  is  that 
disguise  is  required  to  evade  the  censorship.  For 
the  wishes  fulfilled  in  night  dreams  are  either 
those  directly  repressed  or  else  those  closely  as- 
sociated with  the  repressed ;  are,  in  other  words, 
those  of  such  a  nature  that  a  phantasy  depicting 
frankly  and  directly  what  is  wished  for  would  be 
rejected  by  the  censor.  The  disguise  really  has 
the  purpose  of  protecting  the  dreamer  from  real- 
izing what  it  is  he  is  dreaming  about.  As  a  matter 
of  fact  it  is  only  because  of  the  relaxation  of  cen- 
sorship that  occurs  with  sleep  that  many  of  the 
dream  wishes  are  able  to  find  any  representation 
at  all  in  consciousness.  During  the  day  repres- 
sion is  so  strong  that  their  exclusion  would  be 
practically  perfect ;  in  sleep  the  inhibition  by  the 
foreconscious  is  relaxed,  and  the  wish  tensions  of 
the  Unconscious  are  then  able  to  secure  hallucina- 
tory fulfillment  provided  always  that  it  is  so  dis- 


108     MORBID  FEARS  AND  COMPULSIONS 

gnised  and  distorted  as  to  appear  unobjectionable. 

The  dream  then  represents  a  compromise  be- 
tween two  opposed  psychic  streams  or  f  orces,  the 
repressing  force  from  the  foreconscious  which 
would  repudiate  the  wish,  and  the  repressed  trend 
of  the  Unconscious  which  seeks  wish  f ulfiUment 
In  the  dream  both  are  satisfied  in  a  measure.  On 
the  one  hand  the  repressing  stream  can  tolerate 
the  repressed  ideas  corresponding  to  the  wish 
fulfillment  because  their  meaning  is  so  veiled  as  to 
be  unrecognized  and  the  wish  is  not  perceived  by 
consciousness  as  a  wish.  On  the  other  hand  the 
wish  in  the  repressed  stream  finds  representation 
in  consciousness  but  is  forced  to  secure  its  hallu- 
cinatory gratification  in  a  modified  form.  Fur- 
ther conflict  is  thus  avoided  and  the  dreamer  con- 
tinues to  sleep. 

The  amount  of  distortion  and  censoring  which 
the  latent  dream  content  is  made  to  undergo  varies 
directly  with  the  amount  of  repression.  In  young 
children  there  is  little  or  no  repression,  and  so  there 
is  little  difference  between  the  manifest  and  latent 
content  of  their  dreams.  The  dream  of  a  child  can 
be  recognized,  often  without  analysis,  as  a  direct 
fulfillment  of  an  unfulfilled  wish  of  the  preceding 
day.  In  some  dreams  of  adults  that  result  from 
desires  arising  during  sleep,  such  as  the  desire  for 
micturition,  there  is  little  or  no  repression  and 
hence  little  or  no  distortion.  Whatever  distortion 
appears  in  such  dreams  comes  from  their  wishes 
being  associated  with  others  that  are  repressed. 

I  will  now  relate  a  dream  witl\  its  analysis  and 


AN  INTERPRETATION  109 

after  this  take  up  some  of  the  speoial  processes  in 
dream  formation. 

A  young  woman,  a  patient  at  Cornell  Dispen- 
sary, told  me  a  dream  as  follows :  ^^I  dreamed  last 
night  that  I  walked  up  Fifth  Avenue  with  a  girl 
friend.    We  stopped  at  a  millinery  store  and 
looked  at  some  hats  in  the  window.    I  think  that 
I  finally  went  in  and  bought  one/'    The  analysis 
is  as  follows:  When  the  patient  was  asked  what 
was  suggested  to  her  by  a  walk  with  the  girl  of  her 
dream,  she  immediately  thought  of  an  occurrence 
of  the  preceding  day.    On  this  day  she  had  reaUy 
walked  up  the  same  avenue  with  the  same  girl, 
and  looked  at  hats  in  the  same  store  window  that 
she  saw  in  the  dream.    In  real  life  she  bought  no 
hat,  however.    Asked  what  more  came  to  her 
mind,  the  following  occurred  to  her :  On  the  day  of 
the  dream  her  husband  was  in  bed  with  some 
slight  illness  and,  though  she  knew  it  was  nothing 
serious,  she  had  been  terribly  worried  and  could 
not  rid  herself  of  the  fear  that  he  might  die.    On 
this  account,  when  the  friend  of  the  dream  hap- 
pened in,  the  husband  suggested  that  a  walk  with 
this  girl  might  help  her.    After  telling  me  this  it 
also  occurred  to  the  patient  that,  during  the  walk, 
some  mention  had  been  made  of  a  man  she  knew 
before  her  marriage.    When  urged  to  continue, 
she  hesitated  but  finally  said  that  she  believed  that 
at  one  time  she  had  been  in  love  with  him.    Asked 
why,  then,  she  did  not  marry  him,  the  patient 
laughed  and  replied  that  she  had  never  had  a 
chance,  and  then  explained  that  the  man  was  so 


110     MORBID  FEABS  AND  COMPULSIONS 

well  off  and  so  far  above  her  socially  that  she  had 
always  considered  him  out  of  her  reach.  After 
this,  in  spite  of  my  urging,  she  could  not  be  in- 
duced to  pursue  the  subject  f urther,  and  persisted 
in  saying  that  it  had  been  merely  a  silly,  girlish 
affair  which  amounted  to  absolutely  nothing. 

I  then  asked  her  to  think  of  buying  a  hat  and 
relate  everything  this  suggested  to  her.  She  then 
told  me  that  she  had  very  much  liked  the  hats  she 
had  seen  in  the  store  window  and  she  wished  that 
she  could  buy  one  of  them,  though  she  knew  this 
was  out  of  the  question  as  her  husband  was  a  poor 
man.  Evidently  this  wish  is  fulfilled  in  the  dream, 
however,  for  in  it  she  does  buy  a  hat.  But  this  is 
not  alL  She  suddenly  remembered  that  the  hat 
she  bought  in  the  dream  was  a  black  hat,  a  mourn- 
ing hat,  in  fact  I 

This  little  detail,  hitherto  concealed,  when  con- 
sidered with  the  associations  previously  brought 
out,  immediately  gives  the  key  to  the  interpreta- 
tion of  the  dream.  On  the  day  of  the  dream  the 
patient  had  been  fearful  that  her  husband  might 
die.  She  dreams  that  she  buys  mourning,  thereby 
implying  the  phantasy  that  his  death  has  occurred. 
In  real  life  she  had  been  prevented  from  buying  a 
hat  by  the  fact  that  her  husband  was  poor.  In 
the  dream  she  is  able  to  buy  one  and  this  certainly 
suggests  a  husband  who  is  not  poor.  13o  answer 
the  question  of  who  this  rich  husband  might  be,  we 
need  only  turn  to  the  associations  of  the  first  part 
of  the  dream,  i.  e.,  the  man  of  whom  she  refused  to 
talk  and  with  whom  she  might  have  been  in  love. 
He,  as  she  said,  is  well  off  and  as  his  wife  she  could 


LATENT  CONTENT  HI 

bay  hats  as  she  wanted  them.  One  may  therefore 
conclude  that  this  patient  was  dissatisfied  with 
her  husband,  that  she  unconsciously  wished  to  be 
free  from  him  even  at  the  cost  of  his  life,  and  that 
she  longed  to  marry  another  man  who  would  be 
better  able  to  supply  her  wants. 

When  the  patient  was  informed  of  this  interpre- 
tation of  her  dream,  she  not  only  admitted  the 
truth  of  my  conclusions  but,  as  her  resistance  was 
then  broken,  gave  a  number  of  other  facts  in  cor- 
roboration. The  most  important  of  these  was 
that,  after  her  marriage,  she  learned  that  the  man 
whom  she  had  considered  above  her  was  by  no 
means  as  indifferent  to  her  as  she  had  supposed. 
This,  as  she  acknowledged,  tended  to  rouse  her  old 
love  for  him  and  make  her  regret  her  hasty  mar- 
riage, for  she  felt  that  if  she  had  waited  only  a  lit- 
tle longer,  she  might  have  fared  better. 

Let  us  now  consider  some  of  the  processes  at 
work  in  the  formation  of  dreams.  In  the  example 
given,  the  manifest  content  is  the  dream  story  as 
related  by  the  patient.  This  as  we  have  seen, 
gives  expression  in  consciousness  to  certain  un- 
conscious ideas,  the  latent  dream  content,  which 
may  be  stated  about  as  follows:  '^I  am  tired  of 
poverty.  I  do  not  care  for  my  husband.  He  dies 
and  frees  me.  I  marry  the  man  I  prefer  and  so 
am  no  longer  poor."  In  this  dream,  as  is  gen- 
erally the  case,  the  material  forming  the  manifest 
content  (the  representatives  for  the  unconscious 
dream  thoughts)  is  taken  from  the  thoughts  of  the 
day  before.  However,  in  some  dreams,  older  ma- 
terial, often  from  early  childhood,  is  employed. 


112     MORBID  FEARS  AND  COMPULSIONS 

As  in  this  dream,  the  dream  material  usually  ap- 
pears to  concern  matters  which  seem  very  trivial. 

The  conversion  of  the  latent  dream  thoughts 
into  the  manifest  content  is  called  the  dream  work 
(Traumarbeit)  and  is  accomplished  by  the  coop- 
eration of  four  different  processes  or  ^'mechan- 
isms. ' '  The  first  of  these  is  called  Condensation 
(Verdichtung).  This  mechanism  accomplishes 
just  what  its  name  implies.  It  forms  a  conscious 
surrogate  by  abbreviating,  symbolizing,  fusing 
and  condensing  the  unconscious  ideas  of  the  latent 
dream  content.  The  manifest  content  of  the 
dream  is  therefore  laconic.  It  is  always  much 
less  in  extent  than  the  latent  content.  Hence,  it 
follows  that  quite  generally  one  element  in  the 
manifest  dream  represents  several  in  the  latent. 
Such  an  element  is  then  said  to  be  ^'overdeter- 
mined."  This  overdetermination  is  well  shown 
in  the  example  given.  The  purchase  of  a  mourn- 
ing hat  expresses  both  escape  from  poverty,  the 
death  of  a  husband  and  a  new  and  better  marriage. 
Condensation  may  also  produce  a  fusion  of  the 
memories  of  different  scenes  or  objects  into  new 
scenes  or  objects,  different  persons  into  one  com- 
posite person  or  different  words  and  sentences 
into  seemingly  senseless  phrases  or  neologisms. 
Thus  one  of  my  patients  dreamed  that  he  received 
a  letter  signed  *  *  Helva. ' '  This  word,  upon  analy- 
sis, resolved  itself  into  the  two  words  ** Helen*' 
and  "Elva,"  names  which  belonged  to  two  young 
women  with  whom  he  was  anxious  to  correspond. 

An  example  of  condensation  exactly  like  that 
which  occurs  in  dreams  is  afforded  by  the  first  car* 


DISPLACEMENT  113 

toon  given  above.  Essentially  it  is  a  composite 
formed  by  the  fusion  of  the  three  images  into  a 
single  one,  namely  that  of  Mr.  Bryan,  the  dove  of 
peace  and  a  man  with  an  ax*  Similar  examples 
of  condensation  in  dreams  will  be  found  in  the 
dinical  chapters,  for  instance  the  dog  in  the  dream 
of  Miss  Sunderland  (Chapter  IX).  Many  of  the 
most  fantastic  dream  figures,  such  as  strange 
looking  animals,  persons  half  human  and  half 
beast,  are  condensation  products  whose  absurdity 
disappears  as  soon  as  they  are  resolved  into  their 
constituent  elements.^ 

The  second  dream  mechanism  operating  to  form 
the  manifest  content  from  the  latent  is  called 
Displacement  (Verschiebung).  Through  dis- 
placement important  ideas  in  the  latent  content 
are  made  to  seem  unimportant  in  the  manifest, 

• 

1  CondeiiBaiioiiy  a  phenomenon  6f  comparatively  infrequent  oc- 
currence in  the  thought  proceBsee  of  the  foreconsciouB  and  con- 
scious ejrstemB,  is  not  a  peculiarity  of  dream  thinking  per  se  but 
of  unconscious  processes  generaUy.  The  same  may  be  said  of 
displacement,  the  mechanism  we  are  next  to  take  up.  The  exist* 
ence  of  these  peculiarities  of  the  unconscious  processes  bears  wit- 
ness to  the  hig^  importance  of  the  primitive  activation  energies 
being  readily  mobile  and  facile  of  discharge.  The  fact  that  we 
find  these  processes  frequently  occurring  in  the  foreconscious  and 
conscious  systems  only  in  pathological  cases  does  not  indicate 
that  they  are  abnormal  in  themselves.  The  fact  is  th^  are  pri- 
mary in  the  psychic  apparatus;  they  occur  wherever  thoughts 
abandoned  by  foreconscious  activation  are  left  to  themselves  and 
can  fill  themselves  with  uninhibited  energy  striving  for  discharge 
from  the  Unconscious.  They  are,  in  short,  natural  modes  of 
activity  of  the  psychic  apparatus  when  freed  from  foreconscious 
inhibition:  Compare  Chapter  VII  of  Freud's  "Interpretation  of 
Dreams,"  and  his  later  paper,  "Das  Unbewusste."  When  such 
activities  do  reach  consciousness  they  give  rise  to  a  feeling  of 
comicality. 


114    MORBID  FEARS  AND  COMPULSIONS 

while  some  minor  thought  in  the  latent  content 
may  be  represented  as  the  central  feature  in  the 
manifest  part  of  the  dream.  This  mechanism  is 
well  shown  in  the  dream  just  given.  In  it,  the 
walk  up  the  avenue  is  the  most  prominent  portion 
of  the  manifest  content,  though  in  reality  it  is  the 
least  significant  part  of  the  dream.  At  the  same 
time,  the  most  important  part  of  the  dream,  the 
purchase  of  the  hat,  was  given  a  minor  place  and 
mentioned  by  the  patient  almost  as  an  after- 
thought. Thus  the  manifest  content  of  the  dream 
may  said  to  be  eccentric.  Its  central  idea  is  not 
directly  in  line  with  the  central  idea  of  the  latent 
dream  thoughts. 

The  following  cartoon  is  also  an  example  of 
displacement.  The  central  thought  in  its  latent 
content  is  one  of  impatience  over  the  delay  in  set- 
tling the  Lusitania  matter.  This  is  expressed  by 
a  mere  detail  of  the  manifest  content  of  the  car- 
toon, namely  the  long  beards  and  the  aged  appear- 
ance of  the  men  represented.  There  is  nothing  in 
the  cartoon  itself  save  the  word  ^^Lusitania"  to 
indicate  that  it  has  to  do  with  the  sinking  of  a 
great  ship  and  an  international  controversy. 

Equally  important  is  the  displacement  of  af- 
fects. In  the  second  chapter  we  learned  that  an 
unconscious  wish  whose  idea  content  would  be  re- 
fused passage  by  the  censor  might  gain  represen- 
tation in  consciousness  and  access  to  affective 
discharge  by  transferring  its  activation  energy 
to  an  associated  and  more  acceptable  idea.  Many 
such  displacements  occur  in  the  formation  of 
dreams.    Thus  one  finds  in  a  dream  some  emo- 


0oitrt4n  0/  tht  L<rui*vUlt  Timt4 

YoD  BernBtorff  Presents  Lansing  with  Germany 's  Revised 
Answer 


DISPLACEMENT  115 

tion  Buch  as  anger,  love  or  fear  referring  to  an 
image  of  some  logically  indifferent  object,  or  vice 
versa.  This  mechanism  is  responsible  for  the 
fact  that  so  many  dreams  are  made  up  of  trivial 
and  hardly  noticed  impressions  of  the  day  pre- 
ceding. Such  impressions  are  used  in  the  dream 
to  represent  more  significant  ideas  whose  affects 
have  been  transferred  to  them.  One  should  not 
judge  that  a  dream  deals  only  with  trivialities  if 
its  manifest  content  seems  trivial.  The  following 
dream  is  an  example  of  this  fact. 

A  young  woman  suffering  from  a  compulsion 
neurosis,  dreamed  that  there  was  at  her  house 
some  person  (whose  identity  in  the  dream  was 
very  vague)  toward  whom  she  felt  herself  in- 
debted for  many  attentions.  Wishing  to  recipro- 
cate in  some  way,  she  offered  her  hair  comb  for 
this  person's  use.  This  is  all  there  was  of  her 
dream.  Judging  from  its  manifest  content  one 
would  hardly  expect  that  it  dealt  with  anything  of 
great  importance. 

As  an  introduction  to  the  understanding  of  this 
dream  I  should  state  that  the  patient  is  a  Jewess 
and  that  about  a  year  before  this  dream  occurred 
a  young  man,  a  Protestant,  fell  violently  in  love 
with  her  and  besought  her  to  marry  him.  She 
liked  him  very  much,  and,  as  she  explained  to  me, 
had  it  not  been  for  the  difference  in  race,  she  could 
easily  have  reciprocated  his  feeling.  But  not  only 
did  ^e  regard  the  question  of  race  and  religion  as 
important  in  itself  but  even  more  so  as  applied  to 
the  matter  of  children.  Marriages  between  Jews 
and  Gentiles  turned  out  well  enough,  according  to 


116     MOEBID  FEARS  AND  COMPULSIONS 

her  observation,  so  long  as  there  were  no  childreni 
^4  but  as  soon  as  children  came  and  the  question 
arose  as  to  whether  they  should  be  brought  up  as 
Jews  or  Christians,  the  situation  at  once  became 
complicated,  and,  it  seemed  to  her,  trouble  and  un- 
happiness  invariably  resulted.  In  view  of  this 
she  had  schooled  herself,  she  stated,  not  to  care 
for  her  Christian  admirer. 

The  dream  which  I  have  related  occurred  one 
night  after  she  had  had  a  violent  quarrel  with  her 
mother,  as  a  result  of  which  (when  she  retired  for 
the  night)  she  reproached  herself  for  the  trouble 
she  was  continually  causing,  and  decided  that  it 
would  be  better  for  both  herself  and  her  family  if 
she  did  not  live  at  home.  She  fell  asleep  thinMng 
of  ways  and  means  to  get  away  from  home  and  to 
support  herself  without  calling  upon  her  family 
for  assistance.  Once  asleep,  she  had  the  dream 
just  related.  In  the  light  of  these  facts  as  to  the 
setting  the  interpretation  of  the  dream  is  very 
easy. 

Without  going  into  details,  I  may  say  that  the 
person  in  the  dream  to  whom  she  felt  indebted  for 
many  attentions  represented  her  Gentile  lover,  for 
whom,  as  I  have  said,  she  had  schooled  herself 
not  to  care  because  of  the  question  of  children. 
The  offer  of  her  comb  in  the  dream  refers  to  this 
question,  for  in  telling  what  she  associated  with 
the  comb  she  mentioned  that  when  one  person  is 
about  to  use  another's  comb  or  brush  the  remark  is 
sometimes  made :  ^^ Don't  do  that ;  you  will  mix  the 
breed."  In  the  dream  the  offer  of  the  comb  for 
another's  use  represents  an  intention  to  mix  the 


DISPLACEMENT  117 

breed  in  the  sense  of  marrying  a  Gentile  and  hav- 
ing children  by  hinu  The  dream  thns  expresses 
as  fulfilled  her  wish  to  accept  her  Christian  lover 
and  corresponds  to  a  reflection  that,  in  view  of  the 
trouble  she  has  at  home,  a  marriage  with  him  in 
spite  of  the  disadvantages  of  mixing  the  breed 
might  be  better  than  remainlAg  with  her  family. 
Thus  the  affective  content  of  a  matter  of  great  im- 
portance,  namely  her  very  real  and  strong  re- 
pressed interest  in  the  Protestant  lover  and  her 
wish  to  give  herself  to  him,  finds  expression  in  the 
dream  by  displacing  itself  to  ideas  apparently 
most  triviaL 

The  third  dream-forming  mechanism  is  known 
as  Dramatization  (Biicksicht  auf  Darstellbarkeiti 
regard  for  presentability ) .  It  concerns  the  means 
by  which  the  thoughts  of  the  latent  content  of  the 
dream  are  represented  in  consciousness.  In  the 
manifest  content  of  a  dream  there  is  no  intellec- 
tual activity.  All  the  thinking  is  done  in  the  Un- 
conscious. ^  The  manifest  content  consists  merely 
of  various  ideas  that  have  been  sifted  from  the 
unconscious  dream  thoughts  by  the  action  of  the 
censor.  These  ideas  are  then  rendered  objective 
in  the  form  of  pictures  (images)  mostly  visual, 
though  tactile,  auditory  or  other  sensory  impres- 
sions do  occur,  and  they  are  comprehended  by  the 

iHie  fact  that  in  some  dreams  inteUectaal  operaticiis  do  ap- 
pear (both  the  forming  of  Judgments  and  the  drawing  of  conclu- 
sions) is  an  apparent  but  not  a  real  contradiction  to  this  state- 
ment. These  processes  originate  not  in  the  manifest  content  but 
in  the  underlying  dream  thoughts.  They  may  be  reproductions 
of  actual  intellectual  operations  that  had  taken  place  previoualyt 
Le.  memories. 


118     MORBID  FEAES  AND  COMPULSIONS 

dreamer  as  something  outside  of  himself.  This 
mechanism  thus  presents  to  the  dreamer  the  rep- 
resentatives of  the  latent  dream  thoughts  by 
dramatizing  them,  so  that  they  are  expressed  as 
in  a  pantomime  or  by  moving  pictures.  This  is 
shown  by  some  of  the  examples  I  have  given. 
This  kind  of  representation,  however,  has  its  lim- 
itations. For  instance,  as  in  a  play,  events  which 
really  extend  over  a  long  period  of  time  have  to  be 
represented  in  a  few  moments.  Logical  relations 
often  can  not  be  represented  at  alL  Thus  ideas 
such  as  **if,^'  **when,''  ^'either,''  ^'because,''  etc., 
cannot  be  pictured  and  usually  no  attempt  is  made 
to  represent  them.  Occasionally  such  relations 
between  the  various  latent  dream  thoughts  are  ex- 
pressed by  spedal  devices.  Thus  thoughts  cor- 
responding to  a  subordinate  clause  are  repre- 
sented in  an  introductory  dream  while  the  ideas 
correspondiQg  to  the  principal  clause  follow  as 
the  main  dream. 

Identity  or  similarity  between  two  ideas  or 
things  or  persons  is  expressed  by  combining  their 
representing  images  (Condensation).  Many  of 
the  dreams  in  the  clinical  chapters  show  this  mech- 
anism. It  is  the  same  as  that  employed  in  the  fol- 
lowing cartoon  from  the  New  York  Tribune,  No- 
vember 26, 1915  (an  excellent  example  of  conden- 
sation) which  expresses  through  a  fusion  of  im- 
ages the  idea  that  this  country  is  like  the  statue  of 
Venus,  or  in  other  words,  is  lacking  in  arms. 

In  connection  with  dramatization  I  desire  to 
mention  two  special  points.  The  first  is  that  the 
dreamer  is  always  represented  in  the  dream  and  is 


Coorli-jv  #/  Ike  Utin    York    Tribuii 

Preparedness 


DRAMATIZATION  119 

nfitially  the  chief  actor  therein.  The  following  is 
an  example.  A  young  lady  dreamed  that,  a  man 
was  trying  to  ride  a  very  frisky  small  brown 
horse.  He  made  three  attempts  but  each  time  was 
thrown  off.  At  the  fourth  attempt  he  was  suc- 
cessful, however,  and  b^an  to  ride  the  horse  up 
and  down.  Apparently  the  dreamer  is  not  repre- 
sented in  this  dream.  Yet  we  know  that  she  must 
be  there,  masquerading  as  the  man  or  as  the  horse. 
This  is  shown  in  the  analysis  as  follows.  When 
the  patient  was  asked  what  horse  suggested  to 
her,  she  suddenly  recalled  that,  when  she  was  a 
little  girl,  her  father  told  her  that  her  surname, 
Gheval,  was  the  French  word  for  horse.  The  pa- 
tient is  smaU,  dark  and  lively.  In  similar  words 
she  had  described  the  horse  of  her  dream.  We 
suspect  therefore  that  this  horse  represents  her- 
self. The  man  of  the  dream  she  recognized  to  be 
one  of  her  most  intimate  friends.  When  she  was 
asked  to  relate  what  came  to  her  mind  about  this 
man  she  finally  confessed  that  she  had  been  carry- 
ing on  a  very  ardent  flirtation  with  him.  He  at- 
tracted her  very  strongly  and  on  three  occasions 
she  had  betrayed  so  much  sexual  excitement  that 
the  man  tried  to  have  intercourse  with  her.  Each 
time  her  moral  feelings  came  to  her  rescue,  how- 
ever, and  at  the  last  moment  she  repulsed  him. 
All  this  is  symbolized  in  the  dream  by  the  three 
efforts  of  the  man  to  mount  the  horse.  But  in 
sleep  the  inhibitions  that  saved  her  while  awake 
were  less  active.  Her  repression  was  relaxed  and 
she  dreamed  that  she  received  the  sexual  gratifica- 
tion for  which  she  really  longed.    This  is  shown 


120     MOEBID  FEAES  AND  COMPULSIONS 

by  the  man's  finally  mounting  the  horse  and  rid- 
ing it  up  and  down. 

This  brings  me  to  the  second  point  which  I 
wish  to  mention.  Any  one  familiar  with  dream 
analysis  would  know  in  a  general  way,  the  mean- 
ing of  the.  dream  just  related  without  having  to 
ask  the  patient  any  questions  or  collect  any  asso- 
ciations. That  is,  in  some  dreams,  of  which  the 
foregoing  is  an  example,  the  latent  content  is  ex- 
pressed by  means  of  symbols  which  nearly  always 
mean  the  same  and,  if  we  are  familiar  with  this 
symbolism,  we  can  often  read  these  dreams  with- 
out depending  on  the  lengthy  process  of  free  asso- 
ciation. This  symbolism  is  not  only  to  be  found 
in  the  dreams  of  all  people,  no  matter  what  their 
language  or  environment,  but  also  it  may  be  de- 
tected in  folk  lore,  myths,  proverbs,  and  ancient 
ceremonies  of  all  nations.  This  is  explained  by 
the  assumption  that,  deep  down  in  the  minds  of 
even  the  most  cultured  people,  there  still  goes  on 
the  same  kind  of  primitive  thinking  that,  in  our 
prehistoric  ancestors,  gave  rise  to  the  legends  and 
customs  that  have  been  handed  down  to  us. 

The  symbolism  in  the  preceding  dream,  an  ani- 
xnal  for  a  person,  riding  for  coitus,  is  very  com- 
mon, and  is  no  doubt  familiar  to  many  readers. 
Others  of  the  many  common  dream  symbolisms 
that  might  be  mentioned  are  the  dream  of  losing 
a  tooth,  which,  in  women,  sometimes  means  a  fan- 
cied fulfillment  of  a  wish  to  have  a  baby,  and  in 
men  usually  signifies  masturbation;  dreams  of 
sword,  spear  or  snake,  all  of  which  usually  sym- 


SECONDARY  ELABOEATION        121 

bolize  the  male  genitals,  or  of  fighting,  dancing  or 
climbing  stairs  which  signify  coitus. 

The  fourth  dream  mechanism  is  known  as  8e(h 
ondary  Elaboration.  It  comes  into  play  after  the 
dreamer  wakes.  For  the  waking  mind  tends  to 
alter  the  recollection  of  the  dream  by  smoothing 
out  its  inconsistencies  and  forming  it  into  a  story 
with  some  semblance  of  logical  sequence.  The 
portions  of  the  dream  most  likely  to  be  affected 
in  this  way  are  those  points  at  which  the  disguise 
of  the  latent  thoughts  is  weakest,  and  the  changes 
in  general  serve  to  strengthen  this  disguise.  In 
perhaps  the  majority  of  dreams  the  role  played 
by  this  mechanism  is  an  insignificant  one.  Exam- 
ples are  not  required. 

The  function  of  the  dream  is  that  of  satisfying, 
in  so  far  as  is  possible,  those  unfulfilled  wishes  of 
the  day  having  a  combined  tension  sufficient  to 
disturb  the  sleeper  and  to  tend  to  wake  him  up. 
The  dream  is  thus  the  guardian  of  sleep.  The 
first  dream  is  a  good  illustration  of  this  function. 
What  was  disturbing  the  sleeper  was  the  fact  that 
he  would  no  longer  be  permitted  to  defend  him- 
self in  the  matter  of  the  child's  death.  But  in  the 
dream  he  imagines  himself  continuing  his  defense 
.  and  with  good  results.  The  dream  phantasy  was 
thus  a  direct  antidote  to  the  reality  which  caused 
the  concern  menacing  his  rest.  We  often  hear 
people  complaining  that  they  rested  poorly  be- 
cause dreams  disturbed  their  sleep.  The  real 
situation  is  the  reverse,  however;  what  disturbed 
their  rest  is  the  tensions  of  unsatisfied  or  conflict- 


122    MOBBID  FEABS  AND  COMPULSIONS 

ing  wishes ;  bnt  for  the  dreams  they  might  have 
slept  even  less. 

In  one  notable  class  of  dreams,  the  nightmares, 
the  sleep-preserting  function  of  the  dream  fails 
and  the  dreamer  awakes  in  fear.  The  origin  of 
the  fear  dream  is  as  follows.  Dne  either  to  nnns- 
ual  relaxation  of  repression  or  to  nnusnal  strength 
of  a  repressed  desire,  the  fancy  corresponding  to 
a  wish  f ulfQIment  has  begmi  to  be  represented  in 
oonsdonsness  with  inadequate  disgoise.  Just  as 
the  dreamer  is  about  to  become  aware  of  what  he 
is  really  thinking,  the  feeling  of  fear  takes  the 
place  of  the  censorship  and  awakens  him  before 
his  dream  is  complete.  The  fear  is  really  con- 
verted desire  (libido)  escaping  from  repression, 
the  same  desire  that  the  dream  phantasy  attempts 
to  satisfy.  Of  the  relationship  between  fear  and 
desire  we  shall  learn  in  detail  in  the  clinical 
chapters. 

The  significance  of  the  dream  for  psychoan- 
alysis grows  out  of  the  fact  that,  as  Freud  says, 
the  dream  is  the  via  regia  to  the  understanding  of 
the  Unconscious.  As  we  shall  shortly  learn  in 
detail,  the  neuroses  represent  a  breaking  through 
of  wishes  of  the  Unconscious  despite  the  control 
of  the  foreconscious,  in  other  words  a  partial 
failure  of  repression.  The  symptoms,  like  the 
dream,  thus  correspond  to  a  compromise  between 
two  psychic  streams,  the  repressed  and  the  re- 
pressing. But  the  wishes  fulfilled  in  the  dream 
are,  as  we  have  said,  repressed  wishes,  and  thus 
arise  from  the  same  part  of  the  personality  as  do 
those  forces  which  in  predisposed  individuals 


DBEAMS  AND  NEUROSIS  123 

represent  the  motive  force  of  the  neuroses. 
Hence  by  stadying  and  analyzing  a  patient's 
dreams  one  gets  direct  information  regarding 
those  trends  responsible  for  the  symptoms  of  his 
neurosis.  And  since,  as  we  shall  shortly  see,  the 
analytic  treatment  largely  consists  in  Uie  physi- 
cian's gaining  and  imparting  to  the  patient  a  full 
knowledge  of  the  impulses  or  wishes  from  which 
the  symptoms  derive  their  motive  power,  dream 
analysis  is  of  infinite  importance.  This  will  be 
so  amply  illustrated  in  the  clinical  chapters  as  to 
make  examples  unnecessary  here. 


CHAPTER  IV 

THB  MEOHAKISMS  OP  PSYCHOFATHOLOOIGAL 

MANIFESTATIONS 

IN  the  preceding  chapter  we  learned  that  the 
manifest  content  of  the  dream  is  formed  from 
the  nnconsdons  dream-thoughts  by  the  opera- 
tion of  certain  techniques  or  processed  which  were 
designated  by  the  not  altogether  satisfactory 
name  of  ^^ Mechanisms.''  Now,  the  same  or  simi- 
lar mechanisms  participate  in  like  manner  in  the 
formation  of  stUl  other  phenomena  which  occur 
in  consciousness  but  have  origin  in  the  unconscious 
processes.  Chief  among  these  are  the  neurotic 
symptoms.  These  mechanisms  likewise  play  a 
role  in  the  mental  activities  of  even  the  most 
normal  people,  on  the  one  hand,  and  in  the  ab- 
normal productions  of  the  insane,  on  the  other. 
They  are  not  in  themselves  abnormal  though  they 
take  part  in  the  formation  of  all  sorts  of  psycho- 
pathological  manifestations. 

We  have  to  have  knowledge  of  these  mechanisms 
in  order  to  interpret  or  explain  any  given  neurotic 
symptom  for  one  or  more  of  them  is  sure  to  have 
participated  in  its  formation.  In  addition  a 
knowledge  of  them  is  required  for  the  interpreta- 
tion of  the  material  which  comes  up  in  the  daily 
work  of  an  analysis — those  ^^descendants  of  the 
repressed"  through  the  study  of  which  we  at  last 

124 


COMPENSATION  125 

gain  msight  into  the  basic  trends  from  which  are 
derived  the  symptoms  themselves.  For  this  rea- 
son I  shall  devote  considerable  space  to  describing 
and  illustrating  these  mechanisms  and  allied  mat- 
ters even  though  their  bearing  on  the  question 
of  fears  and  compulsions  as  such  is  not  entirely 
an  immediate  one.  Unless  we  are  thoroughly 
familiar  with  them  the  report  of  an  analysis  could 
not  readily  be  understood  or  appreciated. 

Not  all  the  examples  to  be  given  are  in  them- 
selves abnormal  or  taken  from  abnormal  persons. 
The  interpretations  are  in  no  case  exhaustive,  for 
that  would  require  a  fuller  description  of  the  de- 
tails of  the  person's  life  than  is  practicable  in  this 
connection. 

(a)    COMFEKSATIOK 

At  the  dose  of  the  chapter  on  the  unconscious 
we  considered  an  example  of  the  forgetting  of  a 
name  and  learned  that  this  forgetting  was  really 
a  phenomenon  of  repression  and  signified  a  pro- 
tective effort  against  the  reproduction  in  con- 
sciousness of  the  painful  group  of  ideas  with 
which  this  name  happened  to  be  associated.  We 
may  now  consider  another  example  of  name  for- 
getting and  we  shall  immediately  be  introduced 
to  a  new  form  of  defense  phenomena. 

Some  time  ago  I  was  for  a  few  days  the  guest 
of  a  certain  married  couple  with  whom  I  am  in- 
timately acquainted.  One  evening  while  my  host- 
ess, her  husband  and  I  sat  reading,  she  suddenly 
looked  up  from  her  book  and  asked:  **Who  was 
it  that  wrote  *  Paradise  Lost'f    Was  it  Dante? '^ 


126    MOBBID  PBABS  AND  COMPULSIONS 

Her  husband  replied  that  she  had  confused  the 
authors  of  ^^ Paradise  Lost"  and  of  the  ^^Li- 
femo/'  and  nothing  more  was  said  at  the  time. 
A  little  while  later  her  husband  left  the  room,  and, 
just  as  I  was  about  to  speak  of  her  forgetting, 
she  herself  brought  up  the  subject  of  psycho- 
analysis by  asking  me  to  explain  a  very  annoying 
feeling  which  she  had  for  some  time  experienced. 
This  feeling  consisted  in  a  sense  of  aversion  or 
repugnance  toward  all  young  men  with  light  hair 
and  blue  eyes.  She  had  been  caused  much  dis- 
comfort by  this  singular  antipathy  as  a  number 
of  her  husband's  friends  belonged  to  this  type, 
and  their  frequent  visits  to  her  house  always 
made  her  uneasy  and  unhappy.  She  realized  per- 
fectly that  there  was  nothing  in  the  character  or 
behavior  of  these  men  to  justify  her  peculiar  feel- 
ing, but  all  her  efforts  to  reason  it  away  had  been 
of  no  avail.  There,  obviously  enough,  was  an 
affective  reaction  the  source  of  which  must  have 
been  in  the  Unconscious.  No  introspective  effort 
on  her  part  had  furnished  conscious  data  suffi- 
cient to  explain  it. 

Pursuing  the  technique  of  free  association, 
with  which  we  have  already  become  familiar,  I 
asked  her  to  fix  her  mind  on  the  particular  type 
of  man  she  had  described,  and  to  relate  all  her 
incoming  thoughts,  expecting  that  in  this  manner 
she  would  produce  descendants  of  the  unconscious 
trends  causing  her  strange  aversion  and  sufficient 
to  give  some  insight  as  to  its  nature.  In  response, 
she  reported  that  she  found  herself  thinking  of  a 
certain  blond  man,  with  whom  we  are  both  slightly 


COMPENSATION  127 

aoquainted,  next  of  another  of  much  the  same 
appearance  whom  also  she  knew  only  slightly. 
Then,  after  a  short  panse,  she  suddenly  laughed, 
blushed  and  said  with  some  confusion,  ^^I  just 
now  thought  of  some  one  else/'  Having  had 
from  the  start  some  rather  definite  suspicions  as  to 
the  general  significance  of  her  antipathy  to  blond 
men,  I  asked  at  this  point:  '^And  towards  this 
man  you  felt  no  aversion?''  She  at  once  ad- 
mitted that  I  had  guessed  correctly,  and  then 
went  on  to  relate  what  follows,  which,  as  may  be 
fieen,  affords  an  explanation  both  of  her  dislike 
of  light  haired  men  and  also  of  her  failure  to  re- 
member who  wrote  "Paradise  Lost." 

The  man  she  had  thought  of  was  her  first 
cousin.  He  is  a  very  handsome  specimen  of 
the  blond,  blue-eyed  type  that  later  inspired  feel- 
ings of  repulsion.  When  she  was  about  sixteen 
years  of  age  she  had  seen  a  good  deal  of  this  man 
and  had  found  herself  falling  seriously  in  love 
with  him.  But  because  of  their  close  relationship 
and  the  fact  that  he  was  nearly  ten  years  her 
senior,  she  had  decided  that  it  was  very  wrong  in 
her  to  entertain  any  amorous  regard  for  him. 
She  had  therefore  resisted  his  attractions  and 
endeavored  to  banish  from  her  mind  all  senti- 
mental thoughts  concerning  him.  These  efforts 
at  repression  were  apparently  successful  for,  bjs 
far  as  she  was  aware,  he  had  ceased  to  be  of  any 
particular  significance  in  her  emotional  life.  But 
this  complex,  though  it  had  become  in  great  part 
unconscious,  was  by  no  means  entirely  deprived  of 
expression.    For  instance,  when,  just  before  her 


128    MORBID  FEARS  AND  COMPULSIONS 

marriage^  she  destroyed  her  collection  of  photo- 
graphs of  former  admirers,  she  "forgot''  to 
destroy  the  only  picture  she  had  of  her  cousin. 

This  forgetting  we  can  hardly  regard  in  any 
other  way  than  as  purposeful.  Unconsciously  she 
desired  to  keep  the  photograph.  This  little  item, 
small  as  it  is,  has  no  mean  significance.  From 
it  we  are  easily  led  to  suppose  that,  in  the  Uncon- 
scious at  least,  more  of  her  holophilic  interest  re- 
mained attached  to  the  memory  of  her  cousin  than 
she  was  consciously  aware  of  or  ready  to  admit. 
In  other  words,  her  efforts  to  forget  him,  instead 
of  annihilating  this  interest,  had  merely  accom- 
plished its  repression.  But  no  sooner  have  we 
made  this  statement  than  we  notice  that  her  aver- 
sion toward  all  light  haired  men  is  a  trend  dia- 
metrically opposite  to  that  which  we  have  just 
assumed  to  exist  in  the  Unconscious.  Are  we 
therefore  to  suppose  that  because  of  this  aversion 
we  must  have  been  wrong  in  assuming  that  toward 
that  particular  Ught  haired  young  man,  her  cousin, 
she  had  feelings  just  the  opposite  of  aversion! 
Hardly.  We  can  better  explain  the  conditions  by 
assuming  that  this  aversion  toward  all  light  haired 
young  men  was  rather  an  overdevelopment  of 
those  trends  or  counter-activations  which  pro- 
duced the  original  repression,  and  that  the  reason 
for  this  overdevelopment  was  that  the  repression 
was  threatening  to  fail  and  required  an  increase 
of  activity  on  the  part  of  the  repressing  forces  in 
order  to  prevent  this.  In  other  words  this  over- 
activity on  the  part  of  these  trends  from  the  fore- 
conscious  served  as  a  correction  or  antidote  for 


COMPENSATION  129 

what  existed  in  her  Unconscious.  Thus  con- 
sciously she  wished  to  forget  her  cousin  and  was 
unwilling  to  care  for  him ;  unconsciously  she  still 
retained  some  love  interest  in  him  and  wished  to 
rememher  hiuL  Her  forgetting  to  destroy  his 
photograph  is  an  expression  of  the  love  trend. 
Her  failure  to  recall  who  wrote  "Paradise  Lost'* 
was  an  effect  of  the  repressing  trend.  For  it  so 
happens  that  her  cousin^  name  was  Milton. 

We  have  thus  been  introduced  to  a  new  form  of 
manifestation  of  unconscious  processes,  in  addi- 
tion to  the  dream  and  the  forgetting  of  names — 
the  two  with  which  we  are  most  familiar — ^that  is 
to  say,  an  exaggeration  or  overdevelopment  of 
conscious  and  f  oreconscious  trends  serving  as  a 
defense  against  unconscious  wishes  of  an  oppo- 
site character,  which  threaten  to  break  into  con- 
sciousness.' This  may  recall  to  us  the  phenom- 
enon known  in  pathology  as  compensatory  hy- 
pertrophy. A  defect  or  deficiency  in  some  organ 
IB  made  up  for  by  an  overdevelopment  and  in- 
crease of  functional  activity  on  the  part  of  the 
same  organ  or  of  its  mate.  Thus  the  effect  of  a 
leaky  heart  valve  is  discounted  by  an  increase  in 
size  and  strength  of  the  heart  muscle,  or  an  in- 
crease in  the  frequency  of  the  heart's  action;  dis- 
ease or  removal  of  one  kidney  results  in  an  in- 
crease in  size  and  functional  capacity  on  the  part 
of  the  other  kidney,  etc. 

The  somewhat  analogous  phenomenon  which 
occurs  in  the  psychic  sphere,  as  has  just  been  ex- 
emplified, goes,  by  the  same  name,  compensation. 
Thus  when  a  given  trend  succumbs  to  repression, 


130    MOBBID  FEABS  AND  COMPULSIONS 

there  osaally  apjiears  what  amounts  to  a  compen- 
satory hypertrophy  on  the  part  of  the  repressing 
foroesi  the  counter-activations  of  the  foreoon- 
scions.  When  the  repressed  trend  is  a  partica- 
larly  strong  one  and  the  repression  maintained 
with  difficulty,  the  counteractivity  on  the  part  of 
the  repressing  trends  is  then  correspondingly  ex- 
aggerated and  the  phenomenon  is  known  as  over- 
compensation.  It  may  be  added  incidentally  that 
some  of  the  energy  manifested  in  the  form  of  the 
compensatory  activities  is  probably  derived  from 
the  same  instinctive  sources  as  the  tendencies  they 
serve  to  repress. 

One  of  the  most  commonly  observed  over-com- 
pensations is  represented  by  the  exaggerated  anx- 
iety so  often  displayed  by  neurotics  over  the 
health  of  some  person  dose  to  them.  Thus  for 
example  a  neurotic  girl  is  continually  in  a  state 
of  alarm  concerning  her  mother.  If  her  mother 
complains  of  being  over  tired  the  girl  thinks  this 
presages  an  apoplexy.  If  the  telephone  rings 
while  her  mother  is  out,  she  thinks  this  is  a  mes- 
sage from  the  police  saying  her  mother  has 
dropped  dead  on  the  street.  If  she  hears  a  noise 
during  the  night,  she  interprets  it  as  her  mother 
choking' in  a  death  agony. 

Or  again  a  married  woman  shows  a  similar  con- 
cern about  her  children.  As  soon  as  they  are  out 
of  her  sight  she  begins  to  worry  about  something 
happening  to  them.  If  a  fire  engine  goes  by  the 
house,  she  has  a  vision  of  it  crushing  their  bodies. 
If  they  are  late  in  coming  home  from  school,  she 
goes  out  to  search  for  them  fearing  they  have 


COMPENSATION  131 

been  killed  or  kidnapped  If  they  oongh  or 
sneeze,  she  is  in  terror  lest  this  be  a  sign  of  im* 
pending  pneumonia. 

Such  exaggerated  concern,  which  ostensibly  in- 
dicates an  affection  of  unusual  strength,  is  hardly 
that  in  either  of  these  cases  but  rather  an  over* 
compensation  for  repressed  wishes  of  a  hostile 
character.  '  The  married  woman  referred  to  was 
unhappy  and  dissatisfied  with  her  husband.  On 
more  than  one  occasion  she  had  allowed  herself  to 
think  that  had  she  no  children  she  would  leave 
him.  Her  exaggerated  concern  over  their  welfare 
thus  serves  to  compensate  for  the  wish  that  they 
might  die  and  allow  her  to  be  free.  In  the  case  of 
the  daughter  who  worried  about  her  mother  a 
similar  state  of  affairs  prevailed.  As  a  little  girl 
she  had  wished  her  mother  might  die  so  she  could 
have  her  father  all  to  herself.  Later  as  a  young 
woman  she  fell  in  love  with  a  man  and  would  have 
married  him  had  it  not  been  for  her  mother 's  op- 
position. Thus  her  unreasonable  worries  about 
her  mother  really  conceal  and  compensate  for  the 
instinctive  wish  that  her  mother  would  die  and 
leave  her  to  the  man  of  her  choice. 

In  these  and  all  other  examples  of  over-compen- 
sation it  is  to  be  seen  that  the  compensating  mo- 
tives belong  essentially  to  the  cultural,  ethical  and 
acquired  group  of  reactions  and  so  to  the  fore- 
conscious.  The  repressed  trends  which  are  com- 
pensated for  are  in  the  main  more  primitive,  and 
are  derived  from  instinct  and  the  unconscious. 

A  not  uncommon  form  of  compensation  for  re- 
pressed sexual  trends  that  are  conceived  by  the 


132     MORBID  FEAES  AND  COMPULSIONS 

subject  to  be  base  or  sinful  is  represented  by  an 
effort  to  divert  the  thoughts  to  some  theme  of  an 
opposite  character  as  for  instance  religious  work, 
philosophical  or  metaphysical  -studies,  the  ascetic 
pursuit  of  music  or  art  An  excellent  example  is 
afforded  by  the  case  of  a  young  woman  who  in  a 
sudden  and  apparently  inexplicable  way  developed 
a  profound  interest  in  Christian  Science.  After 
studying  for  a  short  time  she  announced  herself 
entirely  convinced  of  the  truth  of  its  tenets,  and 
soon  after  became  a  healer.  Then  she  alternated 
between  preaching  its  doctrines  and  railing  at 
doctors  in  a  quite  fanatical  manner,  until  at  last 
she  broke  out  with  neurosis. 

The  analysis  revealed  the  following  facts.  Pre- 
vious to  the  beginning  of  her  interest  in 
Christian  Science  she  had  suffered  from  an  or- 
ganic illness  which  required  the  constant  atten- 
tion of  a  physician  for  a  long  period  of  time.  Not 
unnaturally  she  became  much  attached  to  her 
medical  attendant  and,  though  he  happened  to  be 
a  married  man,  she  got  into  the  habit  of  having 
certain  romantic  phantasies  about  him.  He  in 
turn  soon  began  to  display  more  interest  in  her 
than  is  demanded  by  an  ordinary  professional  re- 
lationship and  shortly  a  little  rather  furtive  love- 
making  began.  Then,  without  further  warning, 
the  doctor  made  what  was  practically  an  attempt 
to  rape  her,  and  before  she  had  time  fully  to  re- 
cover from  the  shock  of  this  experience  (which 
was  not  lessened  by  her  discovery  that  something 
within  her  strongly  impelled  her  to  let  him  have 
his  way)  she  learned  of  his  having  made  a  similar 


COMPENSATION  133 

attempt  with  another  of  his  female  patients  who 
happened  to  be  one  of  her  acquaintances.  Her 
suddenly  bom  Interest  in  Christian  Science  was 
a  reaction  to  her  romance  with  the  doctor  and 
served  as  a  compensation  for  that  stream  of  her 
libido  which  was  applied  to  him.  Thus  in  place 
of  her  love  for  the  doctor  there  appeared  mockery 
and  hate  of  all  medical  men.  In  place  of  sexusl 
interests,  which  to  her  mind  were  of  the  flesh  and 
degrading,  there  appeared  interests  in  the  spirit, 
in  God,  in  religion.  Instead  of  being  absorbed  in 
what  she  had  felt  to  be  bad  she  was  now  steeped  in 
the  g6od.^ 

II  have  often  wondered  if  some  oonsiderable  number  of 
Cauritftian  ScientisiB  are  not  perhaps  cases  parallel  to  this  one; 
bat  my  experience  in  this  direction  is  too  limited  to  allow  me 
to  venture  any  positiye  statements.  I  am  inclined  to  think,  how- 
ever, that  there  is  a  good  deal  to  be  said  on  this  point.  The 
image  of  the  doctor  has  a  most  intimate  relation  with  the  sex 
lifa  The  child  is  early  impressed  with  the  fact  that  the  doctor 
sees  what  nobody  else  sees,  hears  what  nobody  else  hears,  and 
knows  what  nobody  else  knows.  He  could,  if  he  would,  answer 
all  questions  and  satisfy  aU  sexual  curiosity.  In  connection 
with  "playing  doctor"  many  children  have  their  first  gross  sexual 
experiences.  Partly  through  early  impressions  of  the  family  doc- 
tor along  these  lines,  and  partly  through  the  objectiyely  condi- 
tioned rOle  of  guide,  philosopher  and  friend  to  which  the  doctor 
accedes  by  reason  of  the  necessary  intimacies  of  later  life,  it  is 
extremely  common  for  women  to  develop  strong,  even  though 
unconscious,  erotic  attachments  for  their  medical  attendants.  It 
seems  to  me  highly  probable  that  no  small  number  of  the  cases 
of  sudden  conversion  to  Christian  Sdoice  represent  reactions  to 
trends  of  this  sort  which  were  developing  such  strength  as  to 
break  through  foreconscious  control.  I  can  also  trace  one  or  two 
cases  to  the  masturbation  complex.  The  patient  could  not  bear 
to  undergo  examination  and  treatment  at  the  hands  of  a  medical 
man.  She  feared  that  the  secret  guilt  would  be  revealed  by  such 
means.  She  therefore  sought  other  means  of  healing  her  ills 
where  there  would  be  no  danger  of  such  a  revelation. 


134    MOEBID  FEAES  AND  COMPULSIONS 

An  interesting  example  of  compensation  is  af- 
forded by  the  case  of  an  unnsoally  intelligent 
yonng  woman  who,  from  about  the  age  of  eighteen 
had  been  a  most  ardent  and  militant  feminist. 
On  all  such  questions  as  woman  suffrage,  equal 
pay  for  teachers,  marital  reform,  etc.,  she  had 
talked,  written  and  fought  with  the  enthusiasm  of 
a  fanatic.  Her  dream  was  of  a  time  when  woman 
should  be  on  the  same  plane  with  man  in  all  par- 
ticulars, doing  the  same  work,  enjoying  the  same 
rights,  having,  in  short,  complete  equality.  Aside 
from  problems  such  as  these  there  was  very  little 
in  life  that  seemed  to  interest  her. 

There  were  certain  features  of  the  case,  how- 
ever, which,  even  before  she  broke  out  with  a  defi- 
nite neurosis,  might  well  have  indicated  that  her 
absorption  in  these  matters  was  not  entirely  a 
normal  one.  In  the  first  place,  for  any  one  pos- 
sessed of  such  really  unusual  intelligence  and 
knowledge  of  her  subject,  her  methods  were  very 
ill-considered  and  her  results  surprisingly 
meager.  Though  a  very  industrious  worker,  she 
was  an  astonishingly  inefficient  one.  In  addition 
to  this  was  the  fact  that  her  emotions  on  some  of 
the  questions  of  feminism  were  so  markedly  ex- 
aggerated as  to  be  quite  obviously  abnormal.  For 
instance,  the  slightest  suggestion  that  women  were 
in  any  way  inferior  to  men,  even  in  physical 
strength,  would  set  her  in  a  passion  of  the  wildest 
anger  and  let  loose  a  flood  of  vehement  and  for 
the  most  part  unreasonable  denials.  For  her  to 
hear  it  mentioned  that  the  first  coitus  is  painful  to 
the  woman,  or,  for  that  matter,  any  statement  that 


COMPENSATION  135 

tended  to  associate  the  idea  of  pain  with  the  per- 
formance of  the  sex  functions,  wonld  have  a  simi- 
lar maddening  effect,  as  would  a  tale  of  a  man's 
being  brutal  or  domineering  to  a  woman,  compell- 
ing obedience  from  her,  or  treating  her  as  an  in- 
ferior. 

Upon  analysis  this  patient's  violent  warfare 
against  all  forms  of  subordination  of  women  was 
revealed  to  be  very  largely  a  compensation  for  a 
strong  but  imperfectly  repressed  masochistic 
tendency.  That  is  to  say,  the  idea  of  a  man's 
mastering,  domineering  over,  and  inflicting  pain 
and  violence  upon  a  woman,  particularly  in  an 
erotic  way,  strongly  appealed  to  the  patient's  in- 
stincts and  Unconscious,  though  in  the  main  re- 
pellent to  her  conscious  personality.  Some  of  the 
very  stories  of  brutality  and  suggestions  of  subor- 
dination which  most  excited  her  rage  at  the  same 
time  gave  rise  to  intense  sexual  emotions  and  com- 
pelled her  to  masturbate.  Her  militance  against 
the  subordination  of  women  was  thus  in  essence 
an  effort  to  do  away  with  those  sources  of  stimuli 
which,  in  her,  inspired  feelings  she  felt  to  be  mor- 
bid and  shameful. 

I  have  reason  to  believe  that  this  case  of  mili- 
tant feminism  is  not  entirely  unique.  A  cer- 
tain proportion  of  at  least  the  most  mili- 
tant suffragists  are  neurotics  who  in  some  in- 
stances are  compensating  for  masochistic  trends, 
in  others,  are  more  or  less  successfully  sublimat- 
ing sadistic  and  homosexual  ones  (which  usually 
are  unconscious).  I  hope  this  statement  may  not 
be  construed  as  an  effort  on  my  part  to  throw  mud 


136    MORBID  FEARS  AND  COMPULSIONS 

on  woman  suffrage,  for  on  the  whole  I  am  very 
much  in  favor  of  it.  As  a  matter  of  fact  it  is 
nothing  to  the  discredit  of  any  movement  to  say 
that  perhaps  many  of  its  conspicaoos  supporters 
are  neurotics,  for  as  a  matter  of  fact  it  is  the 
neurotics  that  are  pioneers  in  most  reforms.  The 
very  normal  people  who  have  no  trouble  in  ad- 
justing themselves  to  their  environmenti  are  as  a 
rule  too  sleek  in  their  own  contentment  to  fight 
hard  for  any  radical  changes,  or  even  to  take  much 
interest  in  seeking  such  changes  made.  To  lead 
and  carry  through  successfully  some  new  move- 
ment or  reform,  a  person  requires  the  constant 
stimulus  -of  a  chronic  discontent  (at  least  it  often 
seems  so)  and  this  in  a  certain  number  of  in- 
stances is  surely  of  neurotic  origin  and  signifies 
an  imperfect  adaptation  of  that  individual  to  his 
environment.  Genius  and  neurosis  are  perhaps 
never  very  far  apart,  and  in  many  instances  are 
expressions  of  the  same  tendency. 

Compensation  for  an  overdeveloped  and  im« 
perfectly  repressed  sadistic  tendency  seems  not 
infrequently  to  take  the  form  of  a  passionate  de- 
votion to  antivivisectionist  activities.  In  certain 
cases  that  have  come  under  my  notice  the  patients, 
during  early  childhood,  were  exceptionally  cruel 
to  animals,  and  delighted  in  torturing  them.  This 
was  succeeded  by  a  period  of  relatively  perfect 
repression.  Then  when  the  repression  began  to 
fail,  the  antivivisectionist  interests  became  con- 
spicuously manifest.  That  this  interpretation  of 
certain  cases  is  correct  will  not,  I  think,  be  difficult 
to  believe.    One  would  expect  a  person  really 


COMPENSATION  137 

lacking  in  cmelty  and  possessing  a  real  sympathy 
for  children  «nd  animals  to  he  slow  to  suspect  and 
accQse  others  of  being  cruel  to  them.  In  fact  such 
a  person  might  readily  underestimate  the  likeli- 
hood of  such  cruelty  and  refuse  to  believe  in  its 
existence  where  actually  it  did  occur.  At  any 
rate  he  would  welcome,  and  be  relieved  by,  reason- 
able evidence  tending  to  prove  that  where  he  had 
feared  cruelty  existed,  there  was  no  cruelty  at  all* 
But  not  so  the  antiviviseotionists,  if  my  experience 
is  worth  anything.  They  see  all  kinds  of  out- 
landish cruelties  and  barbarities  where  in  fact 
there  are  none,  evidence  to  prove  that  there  is  no 
cruelty  where  they  suspected  it  enrages  rather 
ihan  soothes  them,  and  in  spite  of  their  own  pro- 
fessed tender-heartedness  it  is  impossible  to  per- 
suade them  that  the  rest  of  the  world  is  not  ex- 
treniely  cruel.  This  seemingly  paradoxical  state 
of  affairs  can  be  readily  understood  if  we  remem- 
ber what  has  been  said  about  the  Unconscious. 
Their  tendency  to  see  limitless  and  fiendish 
cruelty  where  nothing  of  the  sort  exists  is  a  prod- 
uct of  the  Unconscious  and  expresses  their  own 
instinctive  pleasure  in  that  very  sort  of  thing. 
Their  warfare  on  cruelty,  real  or  phantastic,  is 
then  a  compensation  for  their  own  unconscious 
sadism  and  represents  an  hypertrophy  and  over- 
activity of  the  counter-activations  of  the  f  orecon- 
scious  serving  to  maintain  a  repression  which  con- 
stantly threatens  to  f  ail.^ 
A  not  altogether  dissimilar  but  more  compli- 

iThe  cruelty  which  such  persons  so  ^  readily  believe  others 
capable  of  is  really  a  projection  of  their  own  sadism,  which  by 


138    MOBBED  FBABS  AND  COMPULSIONS 

caied  form  of  compensation!  which,  however, 
serves  a  valuable  adaptive  purpose,  is  to  be  found 
exemplified  so  commonly  in  the  character  of  men 
of  our  Southern  states  as  to  be  a  popular  rather 
than  an  individual  constellation.^ 

What  I  have  reference  to  particularly  is  the  atti- 
tude of  the  southern  man  to  the  opposite  sex. 
Woman  is  idolized  and  adored  in  the  South  to  a 
degree  that  is  quite  unique.  Nowhere  in  the 
world  is  she  treated  with  more  courtesy,  delicacy, 
respect  and  homage.  Nowhere  is  she  so  consist- 
ently protected,  honored,  deferred  to  and  waited 
upon.  And  nowhere  is  any  act  involving  coarse- 
ness, meanness  or  brutality  to  a  woman  so  little 
tolerated  or  so  summarily  punished.  Chivalry 
toward  women  is  one  of  the  most  conspicuous 
traits  of  the  Southern  character. 

This  attitude  of  exalted  chivalry  is  really  a  by- 
product of  the  influence  of  the  negro  upon  the 
character  of  the  people  of  the  South.  It  is  in 
essence  a  compensatory  development  serving  to 
correct  some  of  the  ill  effects  of  this  influence. 
The  presence  of  an  inferior  race  in  the  environ- 
ment of  the  Southerner,  toward  the  members  of 
which  the  same  limitations  or  inhibitions  of  con- 
duct which  govern  the  relations  with  the  whites 
do  not  prevail,  serves  to  develop  or  keep  alive  the 
inherent  sadistic  tendencies  of  man,  or  at  least  to 

such  means  they  escape  from  peroeiviiig  as  an  endogenous  fores. 
The  mechanism  of  projection  is  discuseed  elsewhere.  (Page  166.) 
1  Certain  adaptive  reactions  characteristic  of  whole  races  or 
peoples  Brill  has  discussed  in  a  most  masterly  study,  shortly  to 
be  published.  His  observations  on  the  p^chology  of  the  Jews  are 
particularly  interesting. 


COMPENSATION  139 

prevent  their  fundamental  repression.  In  his  re- 
lations with  the  negro  the  Southerner  is  (and  if 
we  are  to  believe  him,  he  has  to  be)  somewhat 
barbaric.  The  negro  apparently  needs  a  master. 
He  must  be  dominated.  The  resources  of  fear 
and  pain  cannot  always  be  dispensed  with  in  deal- 
ing with  him.  He  cannot  always  be  governed  by 
the  milder  methods  that  serve  well  enough  for 
laborers  and  servants  who  are  white.  Thus  the 
environment  of  the  Southerner  has  this  peculiar 
f  eature,  reminiscent  of  a  barbaric  age,  which  not 
only  makes  possible  the  relatively  free  exercise  of 
more  or  less  brutal  or  sadistic  tendencies  but  even 
encourages  and  perhaps  denwnds  them.  It  is 
natural,  therefore,  that  southern  men  should  as  a 
class  be  more  sadistic  than  their  northern  neigh- 
bors. That  they  are  so  is  clearly  apparent.  The 
Southerner  is  proverbially  impetuous,  hot  headed 
and  hot  blooded.  He  is  quick  to  resent  an  injury 
and  quick  to  avenge  it.  In  his  anger  he  resorts  to 
physical  violence  and  to  firearms  with  quite  aston- 
ishing readiness.  Call  him  a  liar  and  he  instantly 
responds  with  a  blow.  Injure  him  and  he 
threatens  to  shoot  you;  injure  him  again  and  he 
keeps  his  promise.^ 

lAn  artSele  in  The  Bpeotaior,  an  insurance  journal,  on  "Hie 
Homicide  Record  for  1915"  says:  "Tlie  homicide  impulse  is  most 
strongly  developed  in  the  Southern  and  far  Western  States,  and 
least  so  in  the  New  England,  Middle  Atlantic  and  North  Central 
States."  Memphis,  Tennessee,  had  the  highest  homicide  rate  for 
the  country,  85.9  per  100,000  population.  The  rate  for  New 
York  City  was  4.7.  Reading,  Pennsylvania,  had  the  lowest 
rste,  1.9. 

Of  the  seventy-four  lynchings  which  took  place  in  the  United 
States  during  1915  nearly  one-third  were  oommitted  in  Georgia* 


140    MOEBID  FEAES  AND  COMPULSIONS 

But  it  is  in  the  measures  with  which  he  punishes 
brutality  that  his  own  brutality,  or  as  we  prefer  to 
call  it,  sadism,  is  most  clearly  apparent.  Take, 
for  example,  the  institution  of  lynching,  an  essen- 
tially southern  one,  though  unfortunately  by  no 
means  unknown  in  other  parts  of  this  country. 
Here  we  find  sadistic  tendencies  plainly  express- 
ing themselves  under  the  very  transparent  dis- 
guise of  a  horror  of  the  sadistic.  There  is  little 
room  for  doubt  as  to  the  real  significance  of  these 
occurrences.  Is  it  conceivable  that  without  a 
strong  sadistic  tendency  any  man  would  choose 
to  assist  in  lynching  a  fellow  being  when  the  ptm- 
ishment  of  the  offender  could  just  as  well  be  left 
to  properly  constituted  authorities  f  Would  not 
a  man  lacking  in  brutality  shrink,  no  matter  how 
** public  spirited*'  he  might  be,  from  participating 
in  such  an  act  as  the  burning  of  a  negro  at  the 
stake  t  Would  he  not  infinitely  prefer  to  leave 
to  the  law  the  taking  of  lives,  particularly  in  view 
of  the  fact  that  when  one  joins  a  lynching  party, 
he  can  hardly  escape  some  grave  misgivings  as 
to  whether  it  will  be  the  right  negro  who  will  be 
lynched  f  It  is  true  that  in  many  instances  of 
lynching  the  provocation  has  been  great,  but 
this  is  by  no  means  always  so.  A  good  many 
lynchings  have  occurred  for  some  other  and  much 
less  serious  offense  than  the  ^' usual  crime"  and 
in  many  instances  the  alleged  malefaction  has 
been  so  trivial  as  hardly  to  deserve  being  called 
an  excuse.  The  cause  of  the  lynching  was  not 
anything  that  particular  negro  had  done,  but 
rather  the  exuberance  of  Southern  sadism,  which 


^  COMPENSATION  Ul 

fionthem  environment  has  so  successfully  fostered. 

The  Southerner's  chivalry,  and,  to  a  less  extent, 
his  generosity  and  warmheartedness,  are  very 
largely  compensatory  corrective  reactions  devel- 
oped against  his  strong  and  imperfectly  repressed 
sadism.  His  environment  will  not  admit  of  any 
complete  repression  or  sublimation  of  the  sadis- 
tic tendencies.  He  has  therefore  to  compensate 
for  them  and  perfect  his  adaptations  by  over- 
developing some  corresponding  virtues. 

The  reason  the  compensations  take  the  form 
of  chivalry  is  this :  Tendencies  to  brutality  when 
fostered  always  tend  to  express  themselves  in  the 
sexual  life.  The  sadistic  instinct  is  a  survival  of 
those  evolutionary  periods  when  it  was  normal 
and  necessary  for  men  to  take  delight  in  the  pur- 
suit, capture,  torture  and  killing  of  other  men. 
An  environment  which  fosters  it  by  reproducing 
even  on  a  milder  scale  these  older  conditions 
tends  also  to  reproduce  the  attitude  of  primitive 
times  towards  women.  The  male  in  savage  life 
courted  the  female  with  a  dub.  Marriage  began 
as  a  forcible  abduction  of  the  female  and  con- 
tinued as  a  relationBhip  more  like  that  of  slave 
and  master  rather  than  that  of  husband  and  wife 
in  the  modem  sense.  A  regression  to  this  sort  of 
attitude  is  strikingly  exemplified  in  cases  of  sadis- 
tic perversion,  where  the  sadist  is  impelled  to 
reduce  the  female  of  his  choice  to  a  state  of  slave- 
like subjection,  to  submit  her  to  gross  indigni- 
ties, and  to  inflict  upon  her  various  degrees  of 
violence  and  physical  pain. 

But  an  environment  that  fosters  brutality  in 


142    MOEBID  FEABS  AND  COMPULSIONS 

one  direction  favors  the  growth  of  all  tendencies 
of  that  character.    A  person  can  not  be  brutal 
or  sadistic  in  one  department  of  his  life  without 
fostering  a  tendency  to  the  same  in  all  depart- 
ments of  his  lif  e^  and  particularly  in  the  sexual 
sphere — ^to  specific  sadism.    But  to  be  sadistic 
or  barbaric  to  a  white  woman  is  very  different  to 
the  mind  of  the  Southerner  from  expressing  sudi 
tendencies  toward  a  negro.    A  tendency  to  bar- 
barity of  the  latter  sort  he  can  permit  to  enter 
his  consciousness.    Even  so  flimsy  an  excuse  as 
is  afforded  by  some  of  the  occasions  for  lynching 
is  sufficient  to  reconcile  with  the  foreconscious, 
sadism  in  one  of  the  grossest  forms.    But  sad- 
ism of  the  other  sort  (toward  respected  white 
women)  must  be  firmly  excluded  from  conscious- 
nes6  and  withheld  from  action.    And  thus^  as  if 
to  make  assurance  doubly  sure  against  any  mani- 
festations of  such  impulses  in  the  direction  of  his 
womankind,  the  Southerner  compensates  by  go- 
ing to  the  opposite  extreme.    Instead  of  making 
woman  his  slave  he  places  her  on  a  pedestal  and 
professes  to  be  a  slave  to  her.    Instead  of  in- 
flicting; pain  upon  her,  he  displays  an  exaggerated 
chivalry  and  is  ready  to  defend  and  shield  her 
against  anything  suggesting  violence  even  at  the 
cost  of  his  life.    His  attitude  of  chivalry  and 
gallantry  is,  in  short,  diametrically  opposite  to 
that  of  the  sadist  and  savage.    And  the  reason 
the  Southerner  has  so  consistently  to  maintain  it, 
is  that,  as  regards  the  Unconscious,  he  is  to  such 
a  large  extent  one  with  the  sadist  and  the  savage. 
His  chivalry  performs  the  function  of  correcting 


DISPLACEMENT  143 

and  oompensating  for  this  identity.  It  is  to  his 
character  what  a  blow-out  patch  is  to  an  automo- 
bile tire.  It  covers  a  point  where  trouble  threat- 
ens ;  it  strengthens  a  weak  spot.^ 

A  (b)   DISPIiAOBMEKT 

As  was  indicated  in  the  second  chapter,  the 
codtrol  and  inhibition  which  the  Foreconscious  ex- 
ercises over  the  processes  and  trends  of  the  Un- 
conscious is  none  too  stable  and,  even  in  normal 
persons,  i«  not  perfectly  complete.  The  material 
just  given,  most  of  which  either  belongs  to  or 
borders  on  the  domain  of  the  pathological,  tends 
to  demonstrate  the  instability  of  repression.  The 
phenomena  of  compensation  are,  for  the  most  part, 
representative,  so  to  say,  of  desperate  efforts  on 
the  part  of  the  Foreconscious  to  maintain  the  re- 
pression of  trends  so  strongly  activated  that  the 
repression  constantly  threatens  to  fail.  In  some 
of  our  examples  appears  a  partial  failure  of  re- 
pression. A  part  of  the  energy  of  some  compen- 
satory measures  comes  from  the  repressed  trends 
themselves  and  in  some  instances  retains  their 
qualities.  In  this  way  a  sort  of  compromise  is 
formed  between  the  repressed  and  the  repressing 

lit  maj  lie  noted  that  the  ''Age  of  Chivalry,''  a  period  in 
wlddi  this  highly  eonunendahle  quality  was  carried  to  extremes 
far  snrpaasing  anything  to  be  obeerved  in  the  South,  was  one  in 
which,  aa  in  the  Southo-n  environment,  sadistic  tendaides  were 
on  the  one  hand  fostered  (in  wars,  the  customs  of  dueling,  beating 
servants,  public  whippings,  beheadings,  etc.)  and  on  the  other 
required  to  be  controlled  and  repressed.  Thus  similar  conditions 
in  periods  temporally  remote  from  one  another  called  forth 
practicaUy  identical  adaptive  compensationa. 


144    MORBID  FEARS  AND  COMPULSIONS 

forces  so  that  they  find  simultaneous  expression 
in  a  single  form  of  activity.  Lynching  is  an  ex- 
ample of  this.  In  it  are  expressed  a  sadistic 
tendency  and  a  rage  against  the  sadistic.  The 
tendency  of  some  of  the  anti  viviseetionists  to  see 
unspeakable  cruelties  where  none  exist  and  at  the 
same  time  vehemently  to  condemn  them  has  a 
similar  significance.  So  too  the  sense  of  discom- 
fort and  aversion  experienced  by  the  young  mar- 
ried woman  in  the  presence  of  young  men  with 
light  hair  and  blue  eyes.  Some  of  the  desire  to 
get  away  from  them  came  from  the  repressing 
forces.  Yet  a  part  of  the  unrest  she  felt  in  their 
presence  was  really  love-desire  for  them,  in  a 
somewhat  transformed  state  (or,  more  accurately, 
a  desire  for  the  person  of  whom  they  reminded 
her)  and  was  thus  a  part  of  the  repressed  ener- 
gies. 

The  processes  by  which  the  trends  of  the  Un- 
conscious find  representation  in  consciousness  we 
must  now  view  more  narrowly.  Repression  is  a 
process  that  occurs  at  the  border  between  the  Un- 
conscious and  the  Foreconscious,  and  I  must  now 
emphasize  the  fact  that  it  has  to  do  primarily 
with  ideas.  A  wish  presentation  arising  in  the 
Unconscious  remains  there  repressed  unless  its 
idea-representative  secures  activation  in  the  fore- 
conscious.  This  activation,  according  to  some  of 
Freud's  most  recent  teachings,^  appears  to  be  a 
gaining  of  access  to  the  word  memories  which  are 
only  of  the  Foreconscious.  The  processes  of  the 
Unconscious  are  in  all  probability  wordless,  just 

iBas  UnbewuBste — ^Zeitach.  f.  Aizt.  Psychoanaljse— Vol.  HI. 


4      •w 


DISPLACEMENT  145 

as  the  thought  processes  of  infancy  are  wordless, 
but  nevertheless  contain  ideas  of  things. 

Word  ideas  belong  to  the  conscious  and  f  orecon- 
scious  systems  and  correspond  to  a  higher  de- 
velopmental state  of  the  psychic  apparatus  than 
the  thought  processes  of  the  Unconscious.  So 
that  unless  an  imconscious  excitation  or  wish  suc- 
ceeds in  getting  the  thing-ideas  representing  it 
translated  into  word-ideas  (but  not  necessarily 
into  actual  words),  or,  to  express  it  differently, 
unless  in  the  foreconscious  the  word-memory 
residues  are  activated  which  correspond  to  the 
unconscious  ideational  representatives  of  the 
wish,  it  remains  an  unconscious  and  repressed 
one.  Its  energy  develops  neither  affects,  nor 
movement.* 

In  the  chapter  on  dreams  we  learned,  however, 
that  an  unconscious  wish  could  secure  representa- 
tion in  consciousness  by  indirect  means,  provided 
that  the  ideas  in  the  Unconscious  corresponding 
to  the  wish  were  replaced  by  others  more  accept- 
able to  the  censor.  One  of  these  important  dis- 
torting mechanisms,  which  consisted  of  a  trans- 
position of  the  wish  energy  or  activation  from  its 

1  There  are  no  imoonscious  affects.  One  often  speaks,  to  be 
snre^  of  unconscious  affects  (love,  hate,  guilt,  resentment,  etc.) 
and  this  usage,  though  not  strictly  correct,  is  a  legitimate  clinical 
oonyenience.  An  affect  is  really  a  conscious  sensory  perception 
of  a  bodily  state.  Without  consciousness  it  does  not  exist.  When 
we  speak  of  an  unconsdous  affect  we  mean  either  that  the  affect 
is  really  developed  and  therefore  conscious,  though  attached  to 
some  other  ideas  than  those  originally  representing  it,  or  else 
we  mean  merely  a  potentiality  of  its  development — ^the  tensions 
of  the  Unconscious  that  might  develop  as  affects  of  hate,  love» 
etc.,  if  released  from  foreconscious  inhibition. 


146    MORBID  FEARS  AND  COMPULSIONS 

unconscious  ideas  to  new  and  associated  ideas 
wliich  would  pass  the  censor,  is  familiar  to  us 
under  the  name  of  displacement.  Displacement 
is  a  phenomenon  occurring  not  only  in  dream 
formation.  It  has  also  very  much  to  do  with  the 
formation  of  practically  aU  the  various  kinds  of 
psychoneurotic  and  psychotic  symptoms  and  is 
likewise  very  frequently  exemplified  in  the  hap- 
penings of  normal  mental  life. 

Like  aU  neurotic  symptoms  the  manifestations 
included  under  displacement  are  compromises 
formed  between  repressed  and  repressing  trends. 
The  compromise  consists  in  the  fact  that  though 
the  ideas  which,  in  the  unconscious^  represent 
wishes  or  libido  strivings  remain  repressed  and 
withheld  from  translation  into  word-ideas,  yet  the 
wish-energies  themselves  are  given  access  to  con- 
sciousness and  to  the  avenues  of  expression  as 
feeling  or  action  by  transposing  themselves  to 
word  ideas  of  the  f oreconscious  which  are  ap- 
parently innocent  and  so  passed  by  the  censor- 
ship. 

What  in  the  first  chapter  we  briefly  referred  to 
as  sublimation  is  really  a  sort  of  displacement 
or  at  least  allied  thereto.  By  sublimation  is 
meant  the  utilization  of  the  energy  really  belong- 
ing to  one  of  the  primitive  holophilic  impulses  or 
sexual  components  for  some  higher  and  non-sex- 
ual aim.  The  original  crassly  sexual  aim  of  the 
impulse  is  abandoned  and  the  libido  displaced  to 
find  outlet  in  some  useful  and  socially  valuable 
form  of  activity.^    Thus  the  exhibitionistic  im- 

^One  of  the  most  interesting  contributions  to  tlie  psychology 


DISPLACEMENT  147 

pulse  finds  outlet  in  histrionic  activity ;  the  sadis- 
tic is  sublimated  into  an  interest  in  surgery,  mili- 
tary matters,  business  competition,  etc. ;  the  curi- 
osity impulse  leads  to  istudy,  investigation,  re« 
search  or  philosophical  speculation.  In  many  in< 
stances  the  early  sexual  curiosity  later  leads  to  an 
interest  in  the  study  of  medicine.  What  in  cer- 
tain casc^  was  originally  rebellion  against  the 
authority  of  the  father,  later  becomes  a  devotion 
to  l^;al  reform,  to  socialism,  or  to  other  move- 
ments designed  to  better  the  conditions  of  the 
wage-earning  classes  who  have  to  submit  to  au- 
thority or  to  certain  forms  of  oppression. 

One  of  my  patients  who  in  his  childhood  was 
very  fond  of  his  aged  grandfather  who  was  very 
tender  and  indulgent  with  him,  and  to  much  the 
same  degree  hated  his  mother,  a  rather  puritan- 
ical widow  who  was  extremely  and  unreasonably 
strict  and  severe  with  him,  was  always  seeking  as 
a  little  boy  to  learn  if  there  were  not  some  medi- 
cine that  would  prevent  his  beloved  grandfather 
from  growing  older  and  dying.  Less  openly  he 
kept  on  seeking  for  some  other  medicine  that 
would  quietly  put  his  mother  out  of  the  way. 
As  a  boy  he  took  great  interest  in  doctors,  but 
finding  liiem  somewhat  disappointing  as  regards 
knowledge  of  how  to  preserve  and  prolong  ex- 
istence, his  early  desire  to  possess  the  secret  of 
a  control  of  life  and  death  eventually  found  a 
sublimated  outlet  in  a  passionate  devotion  to  the 
study  of  chemiistry,  which  became  productive  of 

of  Bublim&tioB  is  Brill's  study  of  choice  of  avocation,  to  be  pub- 
Ushed  shortly. 


148    MORBID  FEARS  AND  COMPULSIONS 

socially  valuable  and  financially  profitable  results 
altogether  different  from  the  early  homosexual 
and  hostile  aims  from  which  these  interests  de- 
rived a  large  part  of  their  motive  power. 

But  we  are  more  interested  in  the  pathological 
forms  of  displacement  than  in  that  sort  which  is 
represented  by  normal  sublimations.  Some  of 
the  most  interesting  examples  are  afforded  by  the 
symptoms  of  the  compulsion  neurosis,  a  malady 
which  we  will  consider  in  detail  later.  We  are 
already  acquainted  with  an  example  of  such  dis- 
placement in  the  drug-taking  compulsion  of  the 
young  woman  mentioned  in  the  second  chapter. 
The  energy  driving  this  compulsion  was  specif- 
ically sexual  wishes.  The  ideas  corresponding  to 
these  wishes  were  refused  passage  by  the  censor, 
but  their  energic  content  was  able  to  evade  the 
censorship  by  means  of  displacement  to  the  ap- 
parently innocent  ideas  of  drugs,  against  which 
there  were  no  serious  resistances.  This  obses- 
sive impulse,  like  many  other  compulsive  phenom- 
ena, resembles  in  its  formation  certaia  examples 
of  wit — ^** smutty'*  wit,  particularly.^  iPor  in- 
stance, a  man  says,  in  mixed  company,  that  though 
he  was  brought  up  to  be  religious,  industrious  and 
serious-minded  yet  there  are  periods  when  he  for- 
gets that  it  is  better  to  watch,  with  the  wise  vir- 
gins, than  to  sleep  with  the  foolish  ones.  His 
words,  if  taken  at  their  face  value,  are  perfectly 
innocent,  yet  they  express,  through  the  double 
meaning  of  the  phrase  "to  sleep  with,'*  certain 
ideas  which  his  hearers  would  not  have  tolerated 

1  Oompare  Freud%  "Wit  and  the  Unoonsdoiu.'' 


DISPLACEMENT  149 

had  he  stated  them  directly.  Bat  the  resistances 
of  his  audience,  operating  as  an  inhibiting  force 
upon  open  expression,  he  circumvented  by  a  spe- 
cial technique  in  much  the  same  way  the  f  orecon- 
scious  resistances  of  the  young  woman  just  men- 
tioned were  circumvented  and  certain  essentially 
objectionable  ideas  and  impulses  allowed  expres- 
sion by  the  use  of  equivocal  terms.  In  the  case 
of  this  patient,  the  word-idea,  ^'to  take  medicine'' 
could  represent  two  different  thing-ideas.  One 
was  the  actual  thing-idea  of  taking  drugs,  while 
the  other  afi  the  result  of  an  infantile  sexual 
theory,  the  memory  of  which  had  long  faded  from 
her  consciousness  corresponded  to  the  thought 
*' Something  one  does  to  have  a  baby.''  Yet 
by  virtue  of  this  double  meaning  the  later  thing- 
ideas  of  what  one  does  to  have  a  baby — ^that 
is  to  say,  intercourse — ^and  the  strong  corre- 
sponding impulses,  had  at  their  disposal  a  word- 
idea  to  represent  them  in  consciousness  which 
on  the  one  hand  seemed  totally  innocent,  yet 
on  the  other  contained  their  true  meaning.  Hence 
the  patient  could  release  into  action  a  portion  of 
her  sexual  wish-tensions,  which  had  they  been 
more  plainly  labeled  would  have  been  denied  even 
this  imperfect  outlet. 

A  business  man,  who  had  to  do  a  fair  amount 
of  traveling,  had  a  peculiar  habit  about  catching 
trains.  If  he  planned  to  go  anywhere,  he  would 
not  look  up  a  time  table  to  find  what  time  the 
trains  went  or  what  would  be  a  convenient  one. 
Instead  he  would  take  his  time  about  attending 
to  what  work  he  had  to  do  at  his  office,  and  when 


150    MORBID  FBAES  AND  COMPULSIONS 

this  was  finished,  would  leisnrely  proceed  to  the 
statioDi  where,  if  there  was  no  train  ready  to 
depart  when  he  got  there,  he  would  wait  until  it 
was  time  for  one.  Naturally  this  habit  caused 
him  to  waste  a  good  deal  of  time,  a  fact  which 
he  realized  perfectly,  but  nevertheless  he  would 
not  abandon  it.  He'd  be  dammed,  he  said,  if  any 
railroad  company  could  hurry  him  at  his  office 
and  make  him  adjust  his  work  according  to  the 
demands  of  a  miserable  time  table.  He  would 
go  to  the  station  when  he  got  ready  and  not  be- 
fore, and  neither  the  railroad  company  nor  any- 
body else  might  dictate  when  this  should  be. 

This  habit  was  really  a  displacement  of  im- 
pulses belonging  to  the  father  complex,  and  rep- 
resented a  rebellion  against  the  father's  author^ 
ity.  The  patient's  father  was  really  an  excep- 
tionally fine  man  to  whom  he  was  greatly  at- 
tached. Nevertheless  the  old  gentleman  had  a 
certain  tendency  to  dictatorialness,  from  which 
the  patient  had  as  a  boy  suffered  consideralxly.  It 
was  characteristic  of  his  father  that  when  once 
he  made  up  hifi  mind  he  wanted  a  thing  done, 
it  must  be  done  at  once;  he  would  brook  no  de- 
lay. Thus  when  he  gave  his  son  an  order,  it  mat- 
tered not  what  the  boy  might  be  doing  at  the 
time,  he  would  have  to  abandon  it  instantly  and 
carry  out  his  father's  wish.  Because  of  his  very 
deep  affection  and  respect  for  his  father  the  pa- 
tient very  naturally  repressed  any  resentment 
over  this  impatience,  and  had  no  consciousness 
of  ever  feeling  rebellious  against  the  authority 
which,  during  his  boyhood,  at  least,  the  father 


^ 


DISPLACEMENT  151 

had  exercised  in  no  uncertain  manner.  Any 
snch  rebellions  impnlses  wonld  have  met  with  vig- 
orous resistances  on  the  part  of  the  f  oreconscious, 
if  directed  at  his  so  greatly  loved  father.  They 
could,  however,  through  displacement  evade  the 
repression  and  discharge  themselves  in  some  in- 
different quarter  as  for  instance  against  the  rail- 
road companies.  In  that  connection  he  could  act 
the  way,  which  as  far  as  his  Unconscious  was  con- 
cerned, he  would  at  times  have  liked  to  act  towards 
his  father,  but  from  which  he  was  withheld  by 
resistances  conditioned  by  love  and  respect. 

Instances  of  this  sort  are  very  common.  Some 
rule,  prescription,  specification  or  anything  else 
giving  the  suggestion  of  authority  is  taken  as 
an  object  to  which  to  displace  and  discharge  re- 
pressed impulses  to  rebellion  and  disobedience 
primarily  referring  to  an  authoritative  parent — 
usually  the  parent  of  the  same  sex.  I  recall  a 
young  man  who,  if  he  saw  a  sign:  ''Don't  walk 
on  the  grass,"  would  go  out  of  his  way  to  walk 
on  it.  The  legend:  ''No  smoking"  would  cause 
him  instantly  to  light  a  cigarette  even  though  per- 
haps he  had  just  finished  smoking.  The  direc- 
tion: "Slow  down  to  ten  nules  an  hour"  would 
invariably  impel  him  to  speed  up  his  car.  The 
mania  for  doing  things  forbidden  which  so  gen- 
erally attacks  boys  or  young  men  when  they  first 
go  away  from  home  to  school  or  college  is  really 
a  breaking  through  of  the  impulses  of  rebellion 
against  the  father  which  hitherto  had  been  better 
repressed  but  now  begin  to  find  outlet  by  dis- 
placing themselves  to  almost  anything  that  is 


152    MOBBID  FEAES  AND  COMPULSIONS 

prohibited.  Often  the  thing  done  represents  in 
a  symbolic  way  some  specific  act  forbidden  or 
oondenmed  by  the  father  (usually  a  sexual  one) 
and  thus  two  sorts  of  impulses  find  a  common 
outlet  According  to  Stekel  and  others,  klepto- 
mania has  this  origin.  The  thing  stolen  is  usually 
symbolic  of  some  sexual  thing  unconsciously 
wished  for,  and  which  in  childhood  the  authority 
of  one  of  tiie  parents  stood  in  the  way  of  attain- 
ing. The  stealing  thus  simultaneously  expresses 
through  displacement  the  desire  for  the  thing  or 
experience  in  question  and  the  rebellion  against 
the  parent  whosjB  influence  or  authority  originally 
interfered  with  its  fulfillment.  I  have  had  one 
such  case. 

I  live  on  Long  Island  and  have  my  office  in  an 
office  building  in  New  York.  One  of  my  patients, 
a  writer  by  occupation,  with  whom  I  was  just  be- 
ginning an  analysis,  opened  the  conversation  at 
the  third  visit  with  the  question:  ''How  do  you 
like  having  your  office  away  from  your  house  t" 
Upon  my  replying  that  I  liked  it  very  well,  he  con- 
tinued: '*Well,  it's  the  only  way  to  live.  IVe 
got  to  do  something  of  the  kind.  I  can't  prop- 
erly get  down  to  work  at  home.  There's  some- 
thing always  interfering,  and  my  writing  suffers 
from  it.  I  shall  have  to  rent  a  room  somewhere 
in  an  office  building  away  from  my  house,  where 
there  will  be  no  one  to  bother  or  interfere  with 
me  and  then  I  can  get  down  to  real  work  and  ac- 
complish something,  instead  of  puttering  around 
as  I  do  now." 

He  expressed  himself  with  so  much 


DISPLACEMENT  153 

about  the  home  interfering  with  his  work  that  my 
attention  was  arrested  at  once,  and  I  wondered 
if  we  were  not  dealing  with  a  displacement.  Cau- 
tious questioning  confirmed  my  suspicions  for 
it  became  quite  apparent  that  whenever  he  showed 
a  disposition  to  write,  his  wife  religiously  left 
him  to  himself y  and  took  great  pains  that  neither 
she  nor  the  children  ever  disturbed  him  unless 
it  was  absolutely  necessary.  It  further  devel- 
oped that  he  had  not  felt  it  any  great  handicap 
to  have  to  work  at  home  until  perhaps  seven  or 
eight  months  before  he  came  to  me. 

In  view  of  these  facts  I  at  length  said  to  him ; 
^*  Perhaps  work  is  not  the  only  thing  you  want  to 
do  that  the  home  interferes  with."  He  seemed 
quite  confused  and  startled  for  a  moment  and  at 
last  said  with  an  embarrassed  laugh:  '^I  guess 
you  hit  it  right  that  time^''  whereupon  he  went 
on  to  tell  me  that  for  two  or  three  years  he  and 
his  wife  had  been  gradually  getting  out  of 
touch  with  one  another,  and  the  state  of  sympathy 
and  harmony  which  had  marked  the  early  part  of 
their  marriage  had  been  slowly  replaced  by  one 
of  relative  indifference.  This  had  not  disturbed 
him  greatly  at  first  for  he  had  felt  it  to  be  a  part 
of  the  natural  course  of  things  that  married  peo- 
ple should  eventually  become  more  or  less  tired 
of  one  another  and  thought  that  what  he  was 
experiencing  was  no  exception  to  the  general  rule. 
Also  he  had  vaguely  felt  that,  as  his  devotion  to 
his  wife  became  less,  that  to  his  work  became 
greater,  a  state  of  affairs  with  which  he  was 
quite  well  satisfied.    But  then,  perhaps  about  a 


154    MORBID  FEARS  AND  CDMPULSrONS 

year  before  he  began  treatment  with  me,  he  made 
the  acquaintance  of  a  young  woman,  who  as  time 
went  on  made  it  quite  apparent  that  she  admired 
him  exceedingly  and  would  not  regard  any  atten- 
tions from  him  as  at  all  unwelcome. 

Her  obvious  interest  in  him  had  at  first  merely 
amused  him  and  left  him  quite  indifferent,  but  it 
was  not  long  before  he  found  himself  responding 
to  it  with  a  warmth  of  feeling  that  surprised  him^ 
and  the  next  thing  that  happened  was  that  when 
one  day  they  were  left  alone  together  for  a  few 
moments,  he  threw  his  arms  about  her  and  kissed 
her.  After  this  he  began  to  meet  her  occasionally 
and  indulge  in  some  love-making,  which  however 
did  not  go  very  far.  He  knew  however  that  she 
was  a  very  sophisticated  person  and  in  his  own 
mind  was  perfectly  satisfied  that  if  he  wanted 
sexual  relations  with  her,  she  would  be  completely 
responsive.  She  was  a  very  attractive  and  ap- 
parently passionate  woman,  and  the  knowledge  of 
what  he  might  experience  with  her  exerted  on  him 
a  powerful  appeal,  but  nevertheless  he  hesitated 
to  go  any  further  because  he  was  married,  and  out 
of  regard  for  his  wife.  It  was  the  state  of  con- 
flict and  uncertainty  arising  out  of  this  situation 
that  was  really  the  main  reason  for  his  not  being 
able  to  settle  himself  at  his  work.  His  feeling 
that  his  home  was  interfering  with  his  work  was 
really  a  displacement,  though  in  a  certain  sense 
there  was  an  element  of  truth  in  this  idea.  It  was 
toward  the  possibility  of  a  liaison  with  the  young 
woman  that  his  home  acted  as  an  interference; 
only  secondarily  and  through  this  medium  did 


PBOJECTION  155 

it  interfere  with  his  work.  His  desire  to  get  a 
room  where  he  felt  he  could  work  more  freely  was 
really  a  desire  to  get  away  from  the  inhibiting  in- 
fluence of  his  home  upon  his  desires  toward  the 
young  woman,  or  (what  is  almost  equivalent) 
from  the  inhibition  of  his  conscience. 

There  is  a  form  of  what  might  be  called  diffuse 
displacement  which  results  in  a  state  in  which 
the  person  finds  fault  with  nearly  everything. 
For  instance,  a  woman  when  she  goes  out  to  din- 
ner finds  the  food  too  hot  or  too  cold,  too  salty  or 
not  salty  enough ;  the  dress  she  buys  is  either  too 
tight  or  too  loose,  or  else  the  wrong  color.  Al- 
ways there  is  something  wrong  with  her  servants, 
her  house  or  her  friends,  in  fact,  everything  she 
comes  in  contact  with.  The  explanation  of  this 
continual  dissatisfaction,  apparently  arising  from 
a  multitude  of  minor  things,  is  that  it  really  had 
origin  in  a  dissatisfaction  with  her  life  with  her 
husband,  but  she  had  displaced  it  elsewhere. 

In  succeeding  chapters  we  shall  become  ac- 
quainted with  other  clinical  examples  of  simple 
displacement,  and  no  more  need  be  given,  at  this 
point.  We  will  consider  instead  some  examples 
of  more  complicated  mechanisms,  all  of  which 
more  or  less  involve  displacement,  but  have  their 
special  features  and  are  known  by  different  names. 

(c)    PBOJECTION  AKD  INTROJECTION 

In  early  infancy  the  individual  has  no  com- 
plete appreciation  of  where  the  self  ends  and  the 
external  world  begins.  The  small  hand  the  baby 
sees  before  him  he  does  not  recognize  as  a  part 


156    MOBBID  FEABS  AND  COMPULSIONS 

of  his  own  person.  The  supply  of  milk  that  ap- 
pears at  such  times  as  he  is  beset  with  hunger  is 
not  at  first  referred  to  the  agency  of  another  in- 
dividuaL 
y  In  the  psychological  sphere  in  adult  life,  par- 
ticularly in  abnormal  cases,  occur  phenomena 
which  parallel  this  early  failure  to  distinguish 
between  the  ego  and  the  non-ego.  Thus  on  the 
one  hand  mental  occurrences  belonging  to  the  ego 
are  perceived  by  consciousness  as  of  external  or- 
igin, while,  on  tJie  other,  essentially  external  hap- 
penings are  assimilated  by  the  personality  and 
made  a  part  of  the  self.  The  former  medianism 
is  known  as  projection,  the  latter  as  introjection. 

The  mechanism  of  projection  is  ordinarily  one 
of  defense.  That  which  is  perceived  as  of  exo- 
psychic  origin  represents  trends  or  ideas  which 
are  painful  to  the  conscious  personality  of  the 
individual  and  out  of  harmony  with  the  ruling  im- 
pulses of  the  foreconscious.  A  completely  suc- 
cessful repression  such  as  he  might  desire  would 
drive  them  entirely  from  the  sphere  of  conscious 
N.  perception;  projection  represents  an  effort  at  re- 
pression which  is  only  partially  successful.  Fail- 
ing to  accomplish  obliteration  of  the  disagreeable 
presentations,  the  repression  does  succeed  in  more 
or  less  completely  preventing  the  recognition  of 
ownership.  The  presentations  are  then  seen  as 
of  external  origin,  not  as  manifestations  of  tend- 
encies of  the  individual  himself. 

A  simple  example  of  projection  which  borders 
on  the  pathological  is  the  following.  One  of  my 
patients,  a  widow  of  forty  years  of  age  suffered 


PBOJECTION  157 

from  a  mild  neurosis  which  came  on  shortly  after 
her  husband's  death.  At  the  time  he  died  they 
had  been  living  in  a  suburb  of  New  York.  She 
continued  to  live  there  for  about  a  year  after 
her  bereavement  and  then  moved  to  New  York, 
feeling,  as  she  explained  to  me  later,  that  the 
atmosphere  of  this  small  town  was  largely  re- 
sponsible for  the  nervousness  to  which  she  was 
becoming  subject.  For,  as  she  went  on  to  say,  in 
a  place  so  small  every  one  was  interested  in  every 
one  else's  business  and  to  live  there  meant  being 
continually  under  the  microscope.  She  knew,  she 
said,  that  all  the  townspeople  looked  upon  her  as 
a  ^'designing  widow"  anxious  to  entrap  a  second 
husband,  and  she  could  not  speak  a  civil  word  to 
a  man  without  the  feeling  that  she  was  being 
watched  and  that  everything  she  said  or  did  was 
certain  to  excite  malicious  comment.  This  sort 
of  thing  made  her  extremely  nervous  and  uncom- 
fortable. It  was  to  get  away  from  it  that  she 
finally  moved  to  New  York. 

Without  denying  that  small  town  life  does  ordi- 
narily give  some  objective  basis  for  the  notions  of 
being  watched  and  criticized  from  which  this  pa- 
tient suffered,  I  early  recognized  that  the  external 
facts,  whatever  they  were,  did  not  represent  the 
true  cause  of  the  patient's  complaints.  Her  sense 
of  being  suspected  really  had  origin  in  her  own 
psyche.  What  appeared  to  her  as  thoughts  of 
her  neighbors  was  really  her  own  ideas  external- 
ized through  the  mechanism  of  projection.  For  in 
a  certain  sense  she  was  a  designing  widow  and  had 
reason  to  know  it.    Her  married  life,  though  not 


158    MOBBID  FBABS  AND  COMPULSIONS 

positively  tmhappy,  had  not  been  entirely  satis- 
f actory^  for  her  husband  was  a  very  matter  of  fact 
person  and  failed  to  satisfy  her  sentimental  long- 
ings. In  spite  of  her  loyalty  to  him  the  reflection 
had  on  more  than  one  occasion  crossed  her  mind 
that  his  decease  might  mean  the  opening  of  the 
doors  to  another  relationship  considerably  more 
romantic  than  what  she  had  experienced.  Fur- 
thermore she  found  that  the  craving  for  physical 
sexual  gratification,  which  annoyed  her  littie  dur- 
ing her  husband's  lifetime,  began  after  his  death 
to  be  a  very  insistent  yearning  with  which  she 
found  it  very  difficult  to  deal,  and  not  unnaturally 
she  looked  toward  a  second  marriage  as  a  means 
of  solving  this  problem. 

But  her  conscience  (foreconscious)  was  of  such 
a  quality  as  to  interpose  resistances  against  these 
various  wishes.  She  felt  that  loyalty  to  her  hus- 
band's memory  should  prevent  her  from  enter- 
taining any  dreams  of  a  second  and  more  satisfac- 
tory marriage,  and  that  the  longing  for  sexual  in- 
tercourse, at  least  for  a  woman  of  her  age,  ought 
not  to  be  a  troublesome  factor,  that  she  ought 
easily  to  be  able  to  suppress  it.  Thus  she  re- 
fused frankly  to  admit  to  herself  that  she  really 
was  a  ^'designing  widow''  (in  the  sense  that  has 
been  indicated).  Consequently  the  idea  that  she 
was,  which  she  could  not  completely  repress,  was 
then  perceived  by  her  consciousness  as  something 
her  neighbors  thought,  that  is  to  say,  as  a  pro- 
jection. Her  moving  to  New  York,  which  pur- 
ported to  be  an  attempt  to  get  away  from  the  sus- 
picion and  criticism  of  her  neighbors,  was  really 


PROJECTION  159 

an  effort  to  escape  from  what  she  thought  of  her- 
self and,  natnrallyi  was  imsuocessful. 

A  second  illustration  of  a  very  common  form  of 
projection  occurred  in  the  case  of  a  girl  of  eight- 
een who  came  to  me  suffering  with  attacks  of  in- 
tense pain  in  one  side  of  her  face.  Her  family 
physician  and  one  or  two  other  doctors  who  had 
seen  her  were  not  quite  certain  whether  these 
pains  were  of  organic  origin  (tic  douloureux)  or 
psychicy  that  is  to  say,  hysterical ;  and  she  was  sent 
to  me  to  have  this  question  settled  and,  should  the 
condition  prove  to  be  one  of  hysteria,  for  analy- 
tic treatment.  When,  after  the  first  examination, 
I  intimated  to  the  girl  and  to  her  mother  that  the 
malady  was  not  organic,  the  young  woman  be- 
came very  angry,  and  both  to  me  and  later  to  her 
family  expressed  in  no  uncertain  terms  her  very 
great  contempt  for  me  in  not  being  able  to  rec- 
ognize an  out  and  out  organic  disease  when  I  saw 
one.  Nevertheless  she  eventually  came  to  me  for 
treatment  and  I  was  finally  able  to  establish  that 
her  extreme  emotional  reaction  against  my  view 
as  to  the  nature  of  her  pain  was  essentially  a 
defense  against  the  projected  knowledge  that  I 
was  right. 

For  it  appeared  that  these  attacks  of  pain  came 
on  when  the  young  woman  was  indulging  in  erotic 
day  dreams,  and  then  only;  that  she  never  had 
them  apart  from  these  dreams;  that  they  lasted 
only  as  long  as  she  kept  on  dreaming;  and  that 
she  could  at  any  time  stop  them  by  stopping  the 
day  dream.  Thus  she  had  every  reason  to  know 
that  they  were  of  psychic  rather  than  of  somatic 


160    MOEBID  FEAES  AND  COMPULSIONS 

« 

origin.  She  was  a  Catholic  and  she  knew  that 
if  she  were  to  confess  to  the  priest  that  she  was 
haying  such  phantasies  he  would  tell  her  they 
were  wrong  and  that  she  must  stop  them,  a  thing 
•she  was  unwilling  to  do.  As  a  way  of  evading 
this,  her  mind  formed  a  compromise  in  the  shape 
of  the  pains,  which  served  the  purpose  of  a  punish- 
ment and  a  penance  for  the  phantasies  she  re* 
garded  as  sinful,  and  thus  in  her  opinion  to  a 
certain  degree  absolved  her  from  the  obligation  of 
confessing  them  and  from  the  sin  of  not  doing 
so. 

What  she  attacked  as  a  manifestation  of  my 
stupidity  was  really  a  projection  of  her  own  un- 
willing knowledge  that  her  pains  were  not  or- 
ganic.^ 

Another  projection  phenomenon  displayed  in 
the  same  case  is  as  follows.  The  analysis  which, 
once  begun,  proceeded  for  a  time  with  fair  prom- 
ise of  success,  came  to  a  standstill  when  the  young 
woman  began  to  display  toward  me  an  attitude  of 
the  most  open  hostility  and  antagonism.  This 
was  shortly  explained  as  having  the  following 
origin.  Her  neurosis  began  at  the  time  her  par- 
ents interfered  between  her  and  a  young  man  in 
whom  she  had  become  interested  and  who  pro- 

^  It  iB  not  rare  to  find  neurotic  patients  who  very  much  resent 
being  told  that  their  trouble  is  psychic.  In  my  experience  this 
always  means  that  they  not  only  have  some  reason  for  knowing 
that  the  condition  is  p^chic  but  that  they  connect  it»  usually 
rightly,  with  something  sexual  of  which  they  are  ashamed.  The 
craving  of  the  neurotic  to  find  some  physical  cause  for  his  trouble, 
intestinal  indigestion,  eye  strain,  overwork,  etc.,  is  really  aa 
effort  to  find  some  other  explanation  for  the  neurosis  than  the 
sexual,  which  he  vaguely  senses  to  be  its  real  cause. 


PROJECTION  161 

fessed  to  want  to  many  her.  Her  hostility  to 
me,  as  she  herself  admitted,  developed  when  she 
came  to  the  conclusion  that  the  reason  her  par- 
ents sent  her  to  me  was  that  I  might  be  able  to 
get  so  much  influence  over  her  as  to  make  her 
willing  to  give  up  the  young  man  and  conform  to 
her  parents'  wishes,  a  thing  she  had  asserted 
she  never  would  do  even  if  her  life  depended  on 
it.  The  more  patient  and  sympathetic  I  was  with 
her  and  the  more  I  professed  to  be  quite  indif- 
ferent as  to  what  she  did  about  the  young  man,  the 
more  convinced  she  was  that  this  was  all  a  scheme 
on  my  part  to  get  her  to  like  and  trust  me  so  that 
eventually  she  would  be  willing  to  give  him  up 
to  please  me,  and  consequently  she  became  more 
and  more  stubborn  and  antagonistic. 

As  a  matter  of  fact  she  was  quite  correct  in  feel- 
ing that  a  strong  influence  was  being  brought  to 
bear  upon  her  in  the  direction  of  making  her  give 
in  to  her  parents '  wishes  and  renounce  the  young 
man,  but  she  was  wrong  in  supposing  it  originated 
with  either  them  or  me.  In  reality  it  came  from 
her  own  mind  and  consisted  of  her  own  impulses 
and  wishes  to  give  up  the  young  man  in  order 
to  please  her  parents  and  continue  as  a  dutiful 
daughter.  Thus  the  force  influencing  her  to  give 
up  her  lover,  and  which  she  perceived  as  emanat- 
ing from  me,  was  really  her  love  for  her  parents 
and  her  wish  to  do  whatever  was  pleasing  to  them. 
Her  antagonism  against  me  was  really  an  antag- 
onism to  that  part  of  her  own  self  that  interfered 
with  her  romantic  intentions.* 

1  It  may  be  added  that  she  had  identified  me  with  her  father 


162    MOEBID  FEAES  AND  COMPULSIONS 

It  is  to  be  noticed  that  in  thesd  and  in  all  other 
examples  of  projection  the  reaction  against  the 
ideas  projected  is  really  a  part  of  the  resistances 
cansing  the  projection  and  thus  a  part  of  the  re- 
pressing forces.  Were  it  not  for  these  resist- 
aQces  (these  objections)  to  the  presentation  in 
question,  the  ideas  would  be  frankly  admitted 
and  there  would  be  no  projection.  Thus,  had  not 
the  girl  just  mentioned  felt  that  there  was  a  re- 
proach contained  in  the  assumption  that  her  mal- 
ady was  of  psychic  origin,  she  would  have  been 
relieved  rather  than  angered  that  such  was  my 
opinion  of  the  case,  or  she  would  have  honestly 
recognized  it  herself.  The  phenomenon  of  ''the 
projection  of  a  reproach"  of  which  these  cases 
are  fair  examples,  is  the  basis  for  such  common 
phrases  as  ''A  guilty  conscience  needs  no  ac- 
cuser,*' "The  wicked  flee  when  no  man  pursueth," 
''It's  only  the  truth  that  hurts''  and  the  like. 

The  most  elaborate  examples  of  projection  are 
furnished  by  paranoia  or  major  psychoses  of  the 
paranoid  type.  Detailed  studies  of  such  cases 
are  already  to  be  found  in  the  literature  of  psy- 
choanalysis, the  most  noteworthy  being  Freud's 
analysis  of  the  Schreber  case/  and  shorter  papers 
by  Ferenczi,  Brill  and  others.  I  will  give  some 
brief  examples  of  cases  approaching  the  paranoid 
type. 

A  young  woman  student  had  at  various  times 
a  number  of  delusional  attacks  which  invariably 
began  with  her  becoming  attracted  by  some  one 

and  transferred  to  me  feelings  that  really  belonged  to  him. 
Matters  of  this  sort  will  be  diseussed  shortly. 


PROJECTION  163 

of  her  professors.  She  would  for  a  time  talk  a 
great  deal  about  him,  of  how  able  and  attractive 
he  waSy  but  without  intimating  that  she  was  fall- 
ing in  love  with  him.  Then  she  would  begin  to 
think  that  he  was  falling  in  love  with  her.  This 
would  seem  to  please  and  amuse  her  at  first,  but 
soon  she  would  get  the  notion  that  he  was  hypno- 
tizing her,  and  her  pleasure  would  be  succeeded 
by  anger.  She  would  complain  that  through 
hjrpnotic  influence  he  was  putting  into  her  mind 
all  sorts  of  erotic  phantasies  about  him,  that 
against  her  will  he  compelled  her  to  masturbate 
with  him  in  mind,  that  by  telepathic  suggestion 
he  gave  her  impulses  to  come  to  his  apartment,  to 
have  sexual  relations  with  him,  etc.,  all  of  which 
would  get  her  into  a  state  of  great  rage  and  excite- 
ment and  she  would  have  to  abandon  her  studies. 
Thereupon  the  attack  would  gradually  subside, 
only  to  be  repeated  in  connection  with  some  other 
teacher  when  she  resumed  her  work. 

It  is  apparent  that  this  patient's  delusional 
ideas  were  nothing  but  a  projection  of  her  own 
erotic  interests  in  her  teachers.  What  she  felt 
as  an  hypnotic  or  telepathic  influence  brought  to 
bear  upon  her  froiji  without  was  simply  an  ex- 
temalization  of  her  own  desires.  Her  anger 
against  the. teachers  represented  her  pathological 
resistances  against  these  desires.  Presumably 
had  she  been  able  to  regard  her  sexuality  in  a 
normal  way,  as  something  perfectly  legitimate 
and  wholesome,  what  appeared  as  delusional  at- 
tacks would  otherwise  have  been  ordinary  love 
affairs. 


164    MOEBID  FEAES  AND  COMPULSIONS 

Some  years  ago  I  learned  that  the  father  of 
a  girl  I  was  treating  in  the  dinic  suffered  from 
the  delusion  that  his  wife  was  untrue  to  hiuL  He 
was  madly  jealous  of  the  multitude  of  lovers  he 
supposed  she  possessed  and  kept  the  house  in  a 
continual  uproar  with  his  threats  and  accusations. 
I  thought  little  about  his  condition  at  the  time, 
beyond  sympathy  for  his  family  and  some  mild 
amusement  at  the  idea  of  his  wife  (a  somber,  de- 
pressed and  most  unattractive  Jewish  woman  well 
past  the  menopause)  in  the  role  of  a  Messalina, 
until  there  came  to  the  clinic  no  less  a  person 
than  the  father  himself,  and  the  basis  for  his  de* 
lusions  was  revealed  to  me.  He  had  been  im- 
potent for  ten  years.  This  was  the  reason  he 
thought  his  wife  unfaithful  to  him.  His  own 
dissatisfaction  at  being  impotent  he  had  projected 
to  her.  She  must,  he  believed,  be  dissatisfied  with 
him.  Then  by  elaborating  this  idea  into  the  de- 
lusion that  she  consoled  herself  with  other  men 
he  was  able  to  reproach  her  in  the  same  degree 
that  he  imagined  she  privately  wished  to  reproach 
him. 

Notions  similar  in  content  but  somewhat  dif- 
ferent in  origin  are  represented  by  a  case  of 
morbid  jealousy  in  a  woman.  In  this  case  the 
projected  ideas  did  not  quite  reach  the  delusional 
stage.  The  woman  was  continually  suspicious 
of  her  husband.  If  he  displayed  any  ordinary 
civility  to  another  woman,  she  thought  he  was 
trying  to  flirt.  If  he  was  late  in  coming  home 
from  his  office,  she  was  persuaded  that  a  ren- 
dezvous with  a  chorus  girl  had  caused  his  delay. 


PROJECTION  165 

If  he  informed  her  he  was  called  out  of  town  on 
business,  she  would  be  convinced  that  this  was 
merely  a  ruse  to  spend  a  week  end  with  6ome  one 
of  his  paramours.  The  chief  argument  on  which 
she  based  her  suspicions,  which  at  the  same  time 
discloses  their  meaning,  was  that  her  husband 
rarely  had  intercourse  with  her  more  than  once  or 
twice  a  week.  If  he  were  not  untrue  to  her,  she 
felt,  surely  he  would  want  intercourse  more  fre- 
quently than  that.  She  knew  men,  she  said,  and 
no  one  could  make  her  believe  that  anything  short 
of  having  intercourse  six  or  seven  times  a  week 
would  satisfy  the  creatures,  and  particularly  such 
a  man  as  her  husband. 

This  woman's  ideas  of  her  husband's  infideUty 
were  really  a  projection  of  her  own  imperfect 
sexual  satisfaction.  For  the  facts  were  that  to 
have  intercourse  only  once  or  twice  a  week  did 
not  give  her  complete  relief,  but  left  her  a  prey 
to  erotic  longings  in  the  intervals  and  inclined  her 
to  have  day  dreams  of  relations  with  men  more 
passionate  than  her  husband  appeared  to  be. 
These,  however,  were  facts  that  she  could  not 
face  squarely.  Her  bringing  up  had  led  her  to 
suppose  that  the  woman  should  regard  intercourse 
merely  as  a  wifely  duty  to  be  submitted  to  with 
pious  resignation  out  of  consideration  for  the 
baser  nature  of  the  male.  That  a  true,  gentle- 
woman could  look  upon  it  in  any  other  way  was 
almost  unthinkable.  Hence,  when  with  inter- 
course once  or  twice  a  week  she  was  incompletely 
satisfied,  she  was  caught  between  the  two  horns 
of  a  dilemma.    If  she  granted  that  this  was 


166    MOEBID  FEAES  AND  COMPULSIONS 

enough  to  satisfy  man's  evil  natorei  and  that  her 
husband  really  was  true  to  her^  this  involved  the 
admission  that  she  was  more  passionate  and 
therefore  more  evil  than  even  the  man.  But  if 
she  allowed  that  even  a  lady  might  need  inter- 
course more  than  once  or  twice  a  week,  it  then 
followed  that  her  husband,  who,  being  a  male 
and  therefore  infinitely  more  sensual  than  the 
female,  must  require  it  still  of tener,  which  could 
only  mean  that  he  was  satisfying  himself  else- 
where. She  chose  the  latter  alternative,  for  pain- 
ful as  it  was  to  her  to  think  her  husband  un- 
true to  her,  this  was  less  painful  than  would  have 
been  the  reflection  that  she  was  more  erotic  than 
he.  Had  her  education,  and  consequently  her 
foreconsdous,  been  different,  so  that  she  could 
have  recognized  that  passion  in  a  woman  is  no 
disgrace,  she  could  have  perceived  her  imperfect 
sexual  satisfaction  directly  instead  of  through 
the  roundabout  route  of  projection,  and  then  per- 
haps, instead  of  pushing  her  husband  further 
away  from  her  through  her  unjust  accusations,  she 
might  have  rendered  herself  sufficiently  attrac- 
tive to  him  to  bring  about  the  satisfaction  of  her 
sexual  needs.^ 


1  Theie  two  caaes  are  quite  typical.  Undue  jealouay  in  a  man 
uauallj  means  that  he  has,  or  thinks  he  has,  aome  d^dency  of 
eezual  power.  It  means  in  a  woman  not,  as  many  seem  to  think, 
that  she  is  unusually  in  love  with  her  husband  but  rather  that 
she  is  not  perfectly  satisfied  with  him,  and  often,  that  she  thinks 
if  he  really  knew  her,  He  would  not  be  satisfied  with  her.  In 
most  patients  suffering  from  morbid  jealousy  there  is  an  over- 
aixxataation  of  the  homosexual  component  of  the  libido. 


INTROJECTION  167 

The  mechanism  known  as  Introjectioni  is  as 
yC  was  saidy  a  process  almost  the  reverse  of  that  of 
projection^  Where  in  the  latter  case  the  individ- 
ual narrows  his  ego  to  a  degree  that  processes 
actually  belonging  to  it  are  perceived  as  of  ex- 
ternal origin,  in  the  former  he  broadens  the  self 
to  include  within  it  what  really  belongs  to  other 
persons  or  objects.  Thus  for  example  that  which 
happens  to  some  other  person  causes  him  to  feel 
or  behave  as  if  it  had  happened  to  him  instead. 
This  involves  something  more  than  ordinary  sym- 
pathy. There  is  a  definite,  though  usually  uncon- 
scious, sense  of  oneness  or  continuity  with  the 
other  person.  For  this  reason  the  phenomenon 
is  commonly  known  under  the  term  Identification.^ 

The  phenomena  of  introjection  or  identification 
are  very  common  and  essentially  normal.  It  is 
only  when  carried  to  extremes  that  identification 
becomes  abnormal.  It  is  for  example  a  normal 
part  of  love.  He  who  loves  identifies  himself 
with  the  love-object,  and  that  person's  pains  or 
pleasures,  successes  or  failures,  honor  or  disgrace 
become  in  a  measure  his  own.  It  expresses  a  sort 
of  reco^ition  of  this  love  identification  when  we 
say  of  a  married  couple  that  the  two  have  been 
made  one. 


/ 


lAa  we  shall  learn  shortly,  there  are  really  two  kinds  of 
identiflcation.  The  individual  may  identify  himself  with  another 
person,  which  might  he  called  subjective  or  introjective  ideutifica- 
tion,  or  he  may  identify  one  person  with  another  previously 
known  person,  and  experience  feelings  toward,  or  see  qualities  in, 
the  former  that  really  belong  to  the  latter.  This  is  one  of  the 
many  forms  of  displacement  and  might  be  called  objective  identi- 
fication, but  is  usually  spoken  of  as  Transferoice. 


168     MORBID  FEARS  AND  COMPULSIONS 

We  identify  ourselves  not  only  with  loved  per- 
sons, our  friends  and  the  members  of  our  families, 
but  also  with  things  essentially  impersonal  or  in- 
animate,  our  possessions,  our  country,  its  em- 
blems, customs,  institutions,  etc.  Thus  we  have 
a  sense  of  identity  with  our  house,  our  dog  or 
our  automobile,  and  see  in  them  virtues  peculiar 
and  different  from  those  of  the  houses,  dogs  or 
automobiles  belonging  to  other  people  and  which, 
in  all  tangible  respects,  are  equal  or  superior  to 
our  own.^  The  resident  of  New  York  or  Chicago 
experiences  a  glow  of  personal  pride  on  listening 
to  some  comment  on  the  greatness  of  his  city  (to 
which  in  all  probability  he  has  not  made  the 
slightest  contribution)  or  the  dweller  in  the  coun- 
try may  feel  a  flash  of  resentment  on  hearing  some 
slur  at  country  customs  or  country  manners  even 
though  he  is  as  thoroughly  sophisticated  and  xm- 
provincial  as  well  could  be. 

We  have  also  a  great  tendency  to  identify  our- 
selves with  people  of  importance  who  excite  our 
admiration  but  whom  we  do  not,  in  any  ordinary 
sense,  love.  Such  identifications  usually  corre- 
spond to  a  wish  fulfillment  The  inmate  of  an 
insane  asylum  who  proudly  informs  us  that  he 
is  Alexander  the  Great  and  conquered  the  world, 
or  that  he  is  Jesus  Christ  and  saved  it,  is  merely 
displaying  an  exaggerated  form  of  the  same  kind 

lA  person  who  suffen  from  a  feeling  of  inferiority  may  not 
ahow  this  normal  overestimation  of  his  own  poflaessiOTs,  but  on 
the  contrary  project  to  ererjrthing  that  belongs  to  him  some  of 
his  own  feelings  of  insuificiency,  so  that  whatever  he  has  never 
seems  to  him  as  good  as  the  equivalent  thing  possessed  by  some- 
body else. 


IDENTIFICATION  169 

of  identification  which  enables  ns  to  find  pleasure 
in  such  a  statement  as  that  our  handwriting 
closely  resembles  ex-president  Boosevelt's^  or 
that  our  new  maid  was  formerly  in  the  employ  of 
John  D.  Bockef  eller.  Identifications  of  this  sort 
which  often  lead  to  imitation  have  much  to  do  with 
the  rapid  spread  of  fads  or  fashions  when  once 
adopted  by  the  great  or  near-great. 

We  may  now  consider  some  examples  of  iden- 
tification which  are  taken  from  the  domain  of 
the  pathological,  though  not  all  of  them  are  in 
themselves  abnormal. 

A  young  woman  who  came  to  me  complaining 
of  insomnia  and  a  depression  of  two  years  stand- 
ing, mentioned  during  the  course  of  the  second 
visit  that  the  night  before  she  had  dreamed  of 
Evelyn  Nesbit  Thaw.  I  asked  her,  very  casually, 
what  she  thought  of  Mrs.  Thaw,  whereupon  she 
at  once  launched  upon  a  most  vehement  and  pas- 
sionate defense  of  that  celebrated  young  woman. 
Since  her  emotion  concerning  Mrs.  Thaw,  whom 
she  had  never  even  seen,  was  obviously  excessive, 
I  concluded  the  patient  must  identify  herself  with 
her.  Inasmuch  as  her  defense  had  to  do  entirely 
with  the  question  of  sexual  temptations  to  which 
that  lady  had  been  alleged  to  have  succumbed, 
I  also  decided  that  she  too  must  have  yielded  to 
some  temptations  of  that  character,  and  that  such 
was  the  basis  of  the  identification.  And  this 
proved  actually  to  have  been  the  case.  The  pa- 
tient had  been  seduced  two  years  before  and  this 
experience  was  one  of  the  chief  determinants  of 
her  state  of  depression.    Her  defense  of  Mrs. 


170    MOEBID  FEAES  AND  COMPULSIONS 

Thaw  was  then  in  essence  a  defense  of  herself. 
Several  years  ago  I  was  standing  on  the  plat- 
form of  an  elevated  railway  station  waiting  for 
a  train  when  a  doctor  with  whom  I  am  acquainted 
came  up  and  spoke  to  me.  We  entered  the  train 
together  and  while  we  were  talking  he  noticed  in 
the  headlines  of  the  paper  I  had  been  reading  the 
statement  that  the  Philadelphia  physician,  Dr. 
Crippen,  had  just  been  executed  in  England  for 
the  murder  of  his  wife.  My  companion  at  once 
dropped  the  subject  which  had  previously  engaged 
us,  and  began  to  talk  about  the  case  of  this  un- 
fortunate doctor  and  the  impression  it  had  made 
upon  him.  Ordinarily,  he  said,  he  had  taken  no 
interest  in  murder  trials  and  had  been  completely 
indifferent  to  the  fate  of  the  murderer,  but  this 
case  had  affected  him  profoundly.  Almost 
against  his  will  he  had  followed  it  in  the  papers, 
continually  hopiog  that  either  the  doctor  would  be 
acquitted  or  at  least  get  off  with  life  imprison- 
ment For,  as  he  explained,  it  had  seemed  to  him 
that  for  a  doctor  to  have  to  suffer  the  death  pen- 
alty, a  man  of  education  and  culture  and  devoted 
by  profession  to  the  prolonging  of  life,  was  some- 
thing unspeakably  horrible  and  unjust.  If  such 
a  man  did  commit  murder  there  must  surely  have 
been,  he  felt,  many  extenuating  circumstances. 
^^Who  knows,"  he  cried,  rather  excitedly,  ''just 
what  sort  of  woman  that  man's  wife  wasf  May 
be  he  married  her  with  the  best  intentions  in  the 
world,  only  to  find  that  instead  of  a  friend  and 
companion  he  had  on  his  hands  a  regular  she-devil 
who  continually  pestered  him  in  all  those  sleek 


IDENTIFICATION  171 

and  fiendish  ways  of  which  only  a  woman  is 
capable  I  Who  Imowsf  Perhaps  if  all  the  facts 
came  ont,  the  world  which  now  blames  him  would 
in  true  justice  feel  that  his  wif e,  who  broke  no  law^ 
really  deserved  death  more  than  he!" 

At  this  point  something  in  my  expression  must 
have  betrayed  that  I  involuntarily  saw  more 
meaning  in  his  remarks  than  he  had  expected  to 
convey^  for  he  interrupted  himself  to  say,  with  a 
laugh:  ^'Oh,  you  analyst!  I  suppose  you  know 
all  my  secrets  now  I  Well,  go  ahead  and  tell  me 
what  you  have  discovered.'' 

I  protested  with  well  intended  mendacity  that 
I  had  discovered  nothing  and,  as  by  that  time  the 
train  had  reached  my  station,  we  parted.  A 
couple  of  weeks  later  I  happened  to  meet  the 
doctor  again,  whereupon  he  said:  '^I  know  that 
the  other  day  you  suspected  that  everything  is 
not  well  with  me,  so  I  may  as  well  tell  you  the 
truth,  for  I  really  want  your  advice/'  He  then 
went  on  to  say  that  his  wife  had  turned  out  to  be 
anything  but  the  sweet  and  amiable  companion 
he  had  expected  when  he  married  her,  but  that 
she  was  selfish  and  ill  tempered  and  apparently 
bent  on  doing  everything  in  her  power  to  make 
him  miserable  and  unhappy.  He  was  profoundly 
distressed,  for  he  was  very  much  in  love  with  her 
at  the  time  they  married,  and  even  though  that 
love  had  considerably  waned,  he  still  could  not  re- 
sign himself  to  seeing  her  as  apparently  she  ac- 
tually was,  a  thoroughly  selfish,  unscrupulous  and 
malicious  woman.  He  had  tried  to  be  patient  and 
to  please  her  in  every  way,  feeling  all  the  time  that 


172     MORBID  FEAES  AND  COMPULSIONS 

it  was  perhaps  his  fault  that  she  behaved  in  such 
a  manneri  and  that  if  only  he  made  more  effort 
or  understood  better  how  to  please  her,  the  happy 
state  he  had  imaged  before  their  marriage  might 
really  be  brought  about.  On  the  other  hand, 
though  he  rarely  complaiued  to  her,  he  was  be- 
coming increasingly  subject  to  internal  spasms 
of  rage  and  resentment  against  her  and  at  such 
times  there  would  flash  into  his  mind  all  sorts 
of  murderous  thoughts,  prayers  that  she  might 
die,  images  of  himself  choking  her  or  smashing 
her  head  against  a  wall  and  other  phantasies  of 
a  similar  character,  the  like  of  which  he  had  never 
experienced  before.  It  was  bad  enough,  he  f elt, 
to  have  had  to  make  such  unpleasant  discoveries 
concerning  his  wife's  character  without  being 
compelled  to  add  to  them  equally  unpleasant  ones 
concerning  his  own. 

It  requires  no  further  discussion  to  render  per- 
fectly dear  why  this  doctor  felt  as  he  did  over 
the  case  of  Dr.  Crippen.  His  compulsive  sym- 
pathy for  that  unfortunate  man  was  essentially 
sympathy  for  himself.  For  on  the  basis  of  the 
murderous  thoughts  which,  in  spite  of  himself, 
his  wife  inspired  in  him,  he  identified  himself 
.with  the  murderer.  He  felt  as  if  he  too  were  on 
trial,  and  his  wish  for  the  acquittal  of  the  ac- 
cused and  his  sense  of  injustice  at  the  execution 
were  conditioned  not  by  any  actual  facts  of  that 
man's  case  but  by  features  of  his  own. 

It  may  be  remarked  incidentally  that  this  case 
of  what  appeared  to  be  exaggerated  sympathy  is 
quite  typical  of  manifestations  of  that  kind.    The 


IDENTIFICATION  173 

person  sympathized  with  is  very  frequently,  as 
in  this  case,  some  one  with  whom  the  sympathizer 
unconsciously  identifies  himself  and  his  great  con* 
cem  is  thus  not  so  entirely  altruistic  as  it  might 
at  first  glance  seem. 

Another  and  slightly  different  example  of  iden- 
tification is  as  follows.  I  was  treating  a  young 
man  for  homosexuality  and  during  the  course  of 
one  of  the  early  visits  he  recalled  that  shortly 
after  puberty  there  was  a  time  when  his  feelings 
toward  girls  had  been  quite  normal,  but  that  his 
mother  had  so  vigorously  opposed  all  his  inter- 
ests in  the  opposite  sex  that  after  a  year  or  more 
of  struggle  with  her  he  finally  gave  in,  and  there- 
after had  only  homosexual  attachments.  After 
having  lived  over  again  during  this  visit  the  bit- 
ter conflict  he  had  had  with  his  mother,  which  un- 
til he  spoke  of  it  on  this  occasion  had  for  the 
most  part  faded  from  his  mind,  he  remarked  that 
he  felt  this  discussion  meant  a  great  step  toward 
recovery.  He  added  that  before  he  began  the 
treatment  he  had  had  a  feeling  that  we  would 
suddenly  come  upon  some  discovery,  whereupon 
he  would  all  at  once  be  well,  and  he  now  felt  that 
the  recollection  of  this  warfare  with  his  mother 
was  that  which  he  had  been  expecting.  Upon 
my  asking  him  what  gave  rise  to  this  expectation, 
he  replied  that  probably  it  was  some  case  that  he 
had  read  about  but  could  not  at  the  time  recall. 
Shortly  we  discovered  that  the  case  was  one  men- 
tioned by  Dr.  A.  A.  Brill,  of  a  young  man  who 
suffered  from  an  obsessive  idea  that  he  was  only 
killing  time,  and  took  all  sorts  of  precautions  in 


174    MORBID  FEAES  AND  COMPULSIONS 

order  never  to  waste  a  minute.  From  the  analy- 
sis of  a  dream  Dr.  Brill  discovered  that  the  fig- 
ure of  the  old  man  representing  Father  Time  was 
in  this  patient's  case  a  symhol  for  the  father  and 
that  his  fear  that  he  was  killing  time  really  rep- 
resented a  repressed  wish  to  kill  his  f  ather,  which 
explanation  the  patient  accepted  and  the  obses- 
sion at  once  disappeared.  My  patient,  from  read- 
ing this  case,  developed  the  expectation  that  he 
too  would  get  well  in  this  sudden  way.  This 
meant  that  he  unconsciously  identified  himself 
with  Brill's  patient.  The  basis  for  this  identifica- 
tion was  the  wish  that  his  mother  would  die. 
Such  a  wish  was  altogether  foreign  to  his  con- 
scious thoughts,  but  existed  as  an  unconscious  one. 
So  when  he  read  Brill's  case  the  idea  of  its  simi- 
larity to  his  own  instead  of  being  presented  to  his 
consciousness  directly  and  in  some  such  form  as : 
''I  am  like  that  man  because  I  wished  my  mother 
deoAf^  appeared  as  an  identification  phenomenon 
in  the  shape  of  the  expectation:  ''In  the  analy- 
sis I  too  will  get  well  through  a  sudden  discov- 
ery." He  felt  that  the  discussion  of  the  conflict 
with  his  mother  was  a  matter  of  great  import, 
because  it  tended  to  bring  to  his  mind  that  it  was 
in  this  relation  that  the  wish  that  his  mother  might 
die  mainly  arose.  The  identification  contains  the 
thought:  ''If  my  mother  were  out  of  the  way  I 
would  be  sexually  normal,"  and  this  idea  we  can 
accept  as  pretty  nearly  correct,  if  for  the  word 
"mother"  we  substitute  "mother's  influence." 


RA.TIONALIZATION  175 

(d)   BATIONAUZATIOK 

It  may  have  struck  some  of  my  readers  that  the 
patients  who  famished  the  various  examples  of 
psyehc^athological  reactions  which  have  been  de- 
scribed most  have  been  singularly  blind  about 
themselves  not  to  recognize  at  least  in  some  cases, 
that  these  reactions  were  determined  by  their 
complexes  and  not  to  realize  what  the  reactions 
meant.  One  might  even  go  so  far  as  to  feel  that 
neurotics,  if  these  cases  represent  any  fair  sample 
of  them,  must  be  a  rather  stupid  lot.  As  a  mat- 
ter of  fact,  neurotics,  as  a  class,  are  rather  above 
the  average  in  intelligence  (compulsion  neurotics 
espedally),  and  their  failure  to  understand  them- 
Belves  is  neither  a  function  of  a  lack  of  intelligence 
nor  of  the  neurosis  as  such,  but  results  rather  from 
the  resistances,  numerous  parallels  of  which  are 
to  be  found  in  the  mental  lives  of  even  the  most 
normal.  The  most  well  balanced  people  have 
many  peculiarities  and  shortcomings  which  are  all 
too  apparent  to  their  friends  and  acquaintances 
but  to  which  they  themselves  are  serenely  blind. 
In  fact  it  may  be  said  with  a  fair  degree  of  ac- 
curacy that  neurotics  are  less  blind  to  the  work- 
ings of  their  own  minds  than  are  normal  people,  in 
the  sense  that  the  neurosis  represents  an  unsuc- 
cessfid  effort  to  become  oblivious  to  the  same 
things  that  normal  people  succeed  in  ignoring 
completely.  The  normal  man,  who  feels  that  his 
every  action  springs  from  reason  rather  than 
from  his  complexes,  is  deceiving  himself  more  than 
does  any  neurotic. 


176    MORBID  FEAES  AND  COMPULSIONS 

This  may  seem  a  rather  mireasonable  and  nn- 
justifiable  assertion  and  therefore  demands  ex- 
planation. Ask  of  any  normal  man:  ^^Why  did 
you  do  that?  Why  do  you  like  this?  Why  do 
you  dislike  the  other?"  and  he  is  pretty  certain 
to  give  you  an  explanation  that  seems  plausible 
and  to  his  mind  completely  satisfactory.  He  will 
not  reply:  ''That  action  or  feeling  came  from 
some  of  my  complexes  or  was,  I  suppose,  the  re- 
sult of  something  in  my  Unconscious  and  I  don't 
understand  it  myself. '*  Never,  practically,  will 
one  hear  such  an  admission,  or  anything  that  is 
the  equivalent  of  it.  Our  actions  and  feelings, 
even  when  most  illogical  and  wholly  determined 
by  unconscious  factors,  rather  than  by  reason  and 
judgment,  seem  to  us  either  perfectly  logical  and 
reasonable  and  determined  on  such  a  basis,  or 
else  accidental  and  requiring  no  explanation  at 
all.  This,  as  was  mentioned  ia  the  second  chap- 
ter, is  accounted  for  by  the  fact  that  those  reac- 
tions which  are  determined  by  our  complexes  and 
our  Unconscious  are  almost  invariably  rational- 
ized; that  is  to  say,  furnished  with  an  apparently 
reasonable  and  plausible  explanation,  often  manu- 
factured ex  post  facto,  and  which  is  more  ac- 
ceptable and  agreeable  to  us  than  would  be  a  cor- 
rect understanding  of  the  real  motive  forces.  In 
the  case  of  intelligent  neurotics  these  rational- 
izations are  often  so  extremely  plausible  that  the 
analyst  has  to  be  constantly  on  his  guard  lest  he 
himself  be  deceived  by  them  and  overiook  the  un- 
conscious factors  really  at  work. 

One  of  my  patients  confessed  to  me  that  it  had 


EATIONAUZATION  177 

always  been  his  intention  to  marry  a  rich  girl, 
though  as  a  matter  of  fact  the  girl  he  had  mar- 
ried had  no  money  at  all.  Before  he  became  en- 
gaged he  had  taken  advantage  of  every  oppor- 
tnnity  to  meet,  and  be^in  the  society  of ,  rich  girls, 
hoping  to  find  one  that  would  be  attractive  and 
at  the  same  time  willing  to  marry  him.  I  felt 
somewhat  surprised  that  his  devotion  and  indus- 
try in  this  direction  had  met  with  so  meager  a 
result^  and  so  expressed  myself,  whereupon  he 
explained  that  all  the  rich  girls  he  had  ever  met 
were  so  spoiled  by  their  money  and  so  utterly 
selfish  that  no  matter  how  rich  they  were  he  would 
not  marry  any  one  of  them.  All  of  them,  he  said, 
put  clothes  and  dances  and  yachts  and  cars,  and 
aU  the  other  things  that  money  could  buy,  ahead 
of  love  and  sympathy  and  companionship,  which, 
he  assured  me,  were  to  his  mind  the  vital  features 
of  marriage.  But  though  I  did  not  feel  in  a  posi- 
tion absolutely  to  deny  that  great  wealth  may 
have  a  prejudicial  influence  upon  character,  the 
fact  remained  that  this  man  had  known  a  great 
many  girls  with  money,  and  it  did  seem  rather 
unlikely  that  every  single  one  of  them  had  exactly 
the  same  group  of  faults  which  he  seemed  to  dis- 
cover in  them.  His  failure  to  carry  out  his  in- 
tention to  marry  a  rich  girl  (a  thing  he  had  many 
opportunities  of  doing)  was,  it  appealed  to  me, 
due  in  all  probability  not  so  much  to  the  alleged 
defects  in  the  character  of  the  young  ladies,  as  to 
certain  peculiarities  of  his  own,  while  the  ex- 
planation he  offered  was  not  the  true  one  but  a 
rationalization.    The  real  determining  factor,  as 


178    MORBID  FEARS  AND  COMPULSIONS 

at  length  appeared,  was  his  own  money  complex. 
He  felt  that  rich  girls  would  be  more  interested  in 
money  than  in  companionship  because  to  a  certain 
extent  he  was  that  way  himself.  Since  he  doubted 
if  he  could  care  for  a  girl  who  was  not  rich,  he  was 
compelled  also  to  doubt  whether,  since  he  was 
not  rich,  any  such  girl  would  care  for  him.  He 
could  feel  sure  of  the  love  only  of  a  girl  who  had 
no  money  at  all,  for  such  a  one  would  appreciate, 
he  felt,  the  moderate  amount  of  money  he  did 
have. 

One  of  my  patients  was  engaged  before  he  came 
to  me  to  a  rich  girl  and  expected  to  be  married  in 
about  a  year.  He  then  received  the  news  that 
the  parents  of  his  intended  lost  all  their  money  and 
that  contrary  to  his  expectation  his  bride  would  be 
penniless.  He  then  insisted  that  they  be  mar* 
ried  right  away.  The  reason  that  he  gave  for  this 
was  the  extremely  convincing  one  that  since  the 
girPs  parents  could  now  support  her  only  with 
difficulty,  he  f c^t  that  it  was  only  right  that  he 
should  step  in,  even  though  at  some  inconvenience, 
and  care  for  her  himself.  The  real  reason  was 
as  follows.  He  had  known  the  girl  only  slightly 
when  he  became  engaged  to  her,  and  it  was  the 
fact  that  her  parents  had  plenty  of  money  that 
had  been  one  of  her  attractions.  An  important 
reason  he  married  her  earlier  than  he  had  ex- 
pected was  that  he  was  afraid  that  some  one 
might  think  that  now  her  parents  had  lost  their 
money  he  would  want  to  back  out  of  the  engage- 
ment, which,  o^  a  matter  of  fact,  was  the  very 


Nationalization  179 

thing  he  did  want  to  do,  though  he  would  not  ad- 
mit it  even  to  himself.^ 

Another  patient  gave  me  a  very  lengthy  and 
rather  logical  explanation  of  why  he  was  in  favor 
of  woman  suffrage.  The  farther  course  of  the 
analysis  revealed,  however,  that  the  basic  reason 
for  his  position  was  his  racial  complex.  He  is  a 
Jew  and  had  felt  very  keenly  the  effects  of  the 
anti-Semitic  prejudice  that  prevails  in  New  York. 
He  sympathized  with  women  because  he,  like 
them,  belonged  to  a  group  often  regarded  infer- 
ior and  which  is  denied  some  of  the  rights  and 
privileges  that  certain  others  may  enjoy.  His  in- 
terest in  equality  of  the  sexes  was  really  a  mani- 
festation of  his  more  intimate  and  personal  in- 
terest in  equality  of  races.^  The  reasons  given 
for  his  position  were  simply  a  rationalization. 

At  the  time  of  the  presidential  campaign  of  1916 
another  patient  gave  me  a  very  logically  formed 
set  of  reasons  why  in  his  opinion  every  one  should 
vote  for  Mr.  Wilson's  reelection,  the  principal 
ones  being  variations  of  the  theme:  '^He  kept 
us  out  of  war."  The  real  reason  that  this  pa- 
tient on  all  occasions  took  Mr.  Wilson's  part  and 
defended  him  and  his,  at  that  time,  unwarlike 
policies,  was  that  the  patient  felt  himself  to  be  a 
coward  and  afraid  to  fight.  He  really  thought 
Mr.  Wilson  beloiiged  in  the  same  category  and 

1  ThiB  reaction  is  obviouBly  an  oyer-oompensaiion.  Fortunately 
the  marriage  turned  out  very  well  in  spite  of  this  unpromising 
beginning.  * 

s  In  cases  such  as  this  the  castration  complex  is  sometimes  an 
important  factor. 


180     MOEBID  FEARS  AND  COMPULSIONS 

secretly  despised  him  as  he  despised  himself, 
meanwhile  defending  and  making  excuses  for  him 
as  he  himself  wished  to  be  defended  and  excused. 
The  perfectly  plausible  reasons  he  gave  for  his 
approval  of  Mr.  Wilson  really  had  practically 
nothing  to  do  with  his  position  in  the  matter  but 
were  simply  rationalizations  of  the  attitude  de- 
termined by  his  complexes. 

In  the  case  of  another  patient  who  with  the 
greatest  bitterness  attacked  the  President  in  his 
efforts  to  avoid  war,  meanwhile  giving  a  most 
plausible  and  reasonable  explanation  of  why  he 
did  this,  was  also  displaying  a  purely  complex- 
determined  reaction.  This  young  man  had  quar- 
reled with  his  family,  thinking  that  rather  than 
avoid  an  open  break  with  him  they  would  give  in 
and  do  a  certain  thing  he  wanted.  He  sadly  mis- 
judged them  for  not  only  did  they  fail  to  be  dis- 
turbed by  the  prospect  of  a  rupture,  but  appeared 
to  be  totally  indifferent  as  to  his  fate,  after  it  oc- 
curred, so  that  he  not  only  failed  to  gain  what  he 
wanted  but  lost  many  tldngs  he  had  previously 
enjoyed.  Thus  not  only  had  he  reason  to  feel  that 
he  had  made  a  great  tactical  mistake,  but  at  the 
same  time  he  suffered  from  a  certain  sense  of 
guilt  for  the  attitude  he  had  taken.  But  he  was 
unwilling  to  admit  to  himself  or  to  anybody  else 
that  he  had  been  wrong  in  quarreling  with  his 
family  or  that  there  was  any  reason  he  should  feel 
guilty  over  it.  Hence  he  was  compelled  to  hate 
Mr.  Wilson  or  any  one  else  who  championed  peace 
or  condemned  war,  for  it  was  as  if  that  person 
were  telling  him  in  general  terms  what  his  con* 


BATIONALIZATION  181 

science  was  insisting  in  particular  ones,  namely 
that  peace  was  right  and  his  quarreling  wrong.^ 
I  noticed  that  a  married  woman,  a  patient  of 
mine  whom  I  had  seen  only  four  or  five  times, 
was  invariably  dressed  in  black.  I  supposed  she 
was  in  mourning,  though  she  had  said  nothing 
about  a  death  having  occurred  in  the  family,  and 
at  last  I  asked  her  about  it.  She  replied  that  she 
was  not  in  mourning  and  that  the  reason  she  wore 
black  was  that  she  thought  such  material  was  more 
durable.  This  explanation  seemed  to  me  rather 
imsatisfactory,  for  in  the  first  place  the  woman 
was  sufficiently  well  oflf  not  to  have  to  be  con- 
cerned about  the  durability  of  her  clothing,  and 
in  the  second  it  was  summer  time,  when  black 
clothing  is  particularly  xmcomf  ortable  and  nobody 
wears  it  unless  there  is  some  reason  for  so  doing. 
It  later  developed  that  her  habit  of  dressing  in 
black  had  a  symbolic  significance  and  that  her  ex- 

iAb  familiar  as  I  am  with  the  frequency  with  which  people's 
opinionB  on  all  BOrta  of  objective  matters  are  determined  by  their 
oomplezea  rather  than  the  actual  merits  of  the  case,  it  has  been 
a  never  failing  source  of  surprise  to  me  to  see  the  extent  this  has 
been  true  in  r^^d  to  the  present  war  and  Mr.  Wilson's  policies. 
In  the  case  of  every  one  of  my  patients,  and  for  that  matter  of 
aU  other  persons  with  whom  I  am  well  enough  acquaints  to  be 
able  to  judge  of  their  complezesy  the  individual's  opinion,  whether 
pro-German  or  pro«Ally,  pro- Wilson  or  anti-Wilson,  was  largely 
and  in  most  instances  wholly  determined  not  by  the  facts  known 
to  him  with  r^^rd  to  any  one  of  the  (juestions,  but  rather  by 
his  own  intimate  complexes.  The  reasons  given  for  his  opinion, 
though  in  many  cases  most  plausible  and  convincing,  proved  on 
close  examination  to  be  little  more  than  rationalizations.  I 
doubt  if  any  one  unfamiliar  with  actual  psychoanalytic  work  can 
realize  or  believe  how  entirely  these  statements  are  true,  not 
only  of  neurotics,  but  of  normal  persons  as  well. 


182    MORBID  FEABS  AND  COMPULSIONS 

planation  that  such  clothing  is  more  durable  was 
simply  a  rationalization  of  that  action.  She  was 
dissatisfied  with  her  husband  who  was  a  rather 
prosaic  individual  and  paid  little  attention  to  her; 
though  as  a  girl  she  had  been  very  popular  and 
liked  pretty  clothes  and  masculine  admiration. 
Her  humdrum  husband  had  failed  to  satisfy  her 
craving  to  be  admired  while  her  conscience  forbade 
her  seeking  to  gratify  it  elsewhere.  Her  dressing 
in  black  was  a  symbolic  expression  on  the  one  hand 
of  her  wish  to  be  a  widow  and  receive  attention 
as  of  old,  and  on  the  other  of  penitential  impulses 
for  her  guilty  feeling  that  it  was  her  inordinate 
fondness  for  clothes  and  admiration  that  made  her 
unhappy  with  her  husband,  who  in  many  respects 
was  a  very  considerate  and  worthy  man. 

(e)    VABIOUS  DEFENSE  AND  DISTOBTION 

MECHANISMS 

There  are  a  great  niany  symptoms  or  symptom- 
like formations  which  serve  as  defenses  against  a 
sense  of  guilt.  One  of  these  consists  in  displacing 
the  guilt  affects,  which  repression  has  failed  to 
prevent,  to  the  idea  of  some  other  and  lesser  male* 
faction  than  that  from  which-  they  really  have 
origin.  Thus  a  patient  of  min^who  had  volun* 
teered  to  help  one  of  her  neigi^ors  in  caring  for  a 
very  sick  old  woman,  f  eU  asleep  while  watching  at 
the  sufferer's  bedside  and  was  iti  consequence  half 
an  hour  late  in  administeriiig  a  dose  of  medicine 
that  the  doctor  had  ordered.  When  a  few  days 
later  the  old  woman  died,  my  patient  began  to 
reproach  herself  as  being  guilty  of  her  death,  feel- 


DEFENSE  MECHANISMS  183 

ing  that  if  she  had  given  the  medicine  on  time 
it  might  not  have  occurred.  This  was  despite  the 
fact  that  the  old  woman  had  an  incurable  illness 
from  which  recovery  was  impossible,  and  that  the 
death  occurred  at  just  the  time  it  had  been  pre- 
dicted by  the  doctor.  The  guilty  sense  of  having 
caused  the  old  woman's  death  really  came  from 
another  quarter.  My  patient  was  approaching 
the  forties  without  having  married,  a  circum- 
stance largely  attributable  to  her  mother's  inter- 
ference and  tyranny,  for  she  had  rarely  permitted 
her  daughter  to  have  any  suitors  and  had  soon 
interfered  in  the  case  of  the  few  that  did  present 
themselves. 

The  daughter  had  wished  (even  at  times  con- 
sciously) that  her  mother,  who  was  not  in  the 
best  of  health,  would  die  before  it  would  be  so 
late  as  to  place  marriage  out  of  the  question. 
When  her  mother  did  die,  a  few  months  before 
the  old  woman  just  mentioned,  my  patient  had  a 
vague  sense  that  her  evil  wishes  had  killed  her. 
The  guilty  feelings  arising  in  this  way  she  was 
able  to  keep  down  until,  at  about  the  time  of  the 
death  of  the  old  woman  neighbor,  they  were  aug- 
mented by  the  effect  of  a  certain  sexual  tempta- 
tion to  which  she  was  unexpectedly  subjected. 
Then,  no  longer  able  to  suppress  her  sense  of 
guilt  entirely,  she  partially  escaped  from  it  by 
means  of  the  displacement  just  described. 

Another  method  of  defense  against  guilt  com- 
plexes consists  of  various  sorts  of  penitential 
measures  or  ceremonies.  The  aetion  of  the 
woman  who  wore  black  in  the  summer  time  was 


184    MORBID  PEAES  AND  COMPULSIONS 

in  part  conditioned  in  this  wise.  Another  example 
is  that  of  a  salesman  whose  business  it  was  to 
secore  advertising  for  a  certain  magazine. 
Though  for  a  time  very  successful  at  this  work, 
his  sales  at  length  began  to  fall  off  very  con- 
siderably, to  such  a  degree,  in  fact,  that  he  even- 
tually lost  his  position.  The  reason  for  this 
change  was  that  he  had  become,  as  he  expressed 
it,  ^^over  conscientious."  Instead  of  enthusiast- 
ically explaining  to  the  prospective  advertisers 
the  great  advantages  to  be  expected  to  result  from 
buying  space  in  the  magazine,  as  at  first  he  had 
done,  he  would  ask  himself :  ^ '  Now  really  would 
this  man's  business  profit  by  the  kind  of  advertis- 
ing I  am  supposed  to  sell  himf "  a  question  that 
he  often  felt  had  to  be  answered  in  the  negative. 
On  such  occasions  he  would  be  impelled  to  advise 
the  prospective  purchaser,  against  buying  and 
naturally  made  no  sale.  He  expressed  the  situa- 
tion to  me  by  saying:  **IVe  gotten  so  that  I 
can't  stand  it  to  feel  that  my  clients  are  not  go- 
ing to  get  full  value  received. ' ' 

The  origin  of  this  compulsion,  for  such  it  was 
(in  many  instances  he  advised  against  the  pur- 
chases of  advertising  where  it  really  would  have 
been  of  advantage  to  the  buyer),  wap  from  quite 
another  matter  in  his  life,  in  which  he  had  a  much 
more  logical  reason  to  feel  that  he  was  not  giving 
value  received.  He  had  made  the  acquaintance 
of,  and  eventually  seduced,  a  somewhat  innocent- 
minded  and  unsophisticated  young  girl,  who, 
though  he  had  never  said  so  in  so  many  words,  had 
all  along  had  the  impression  that  he  intended  to 


DEFENSE  MECHANISMS  185 

marry  her.  He  had  not  disabused  her  of  this 
notion,  for  on  the  one  haxid  he  wished  to  con- 
tinue his  sexual  relations  with  her,  and  on  the 
other  dreaded  the  storm  of  tears  and  reproaches 
which  he  knew  would  be  forthcoming  as  soon  as 
she  knew  how  she  had  been  duped.  Meanwhile 
he  tried  to  excuse  himself  by  believing  that  the 
girl  was  not  really  as  innocent  as  she  appeared 
to  be  and  that  if  she  was  foolish  enough  to  expect 
him  to  marry  her  when  he  had  never  in  so  many 
words  promised  that  he  would,  there  was  nobody 
to  blame  but  herself.  Failing  then  to  give  value 
received  in  this  quarter  he  tried  to  make  up  for 
it  in  another,  and  through  the  falling  off  in  his 
conunissions  and  the  eventual  loss  of  his  position, 
suffered  an  essentially  self-inflicted  punishment 
for  the  sin  he  really  believed  he  was  committing 
in  spite  of  all  his  efforts  to  persuade  himself  other- 
wise. 

A  patient  of  mine  who  lived  on  the  seashore 
where  there  was  an  excellent  bathing  beach  of 
which  nearly  every  one  took  advantage,  had  a 
marked  aversion  to  going  into  the  water,  in  spite 
of  the  fact  that  he  was  well  able  to  swim.  It  was 
not  through  any  idea  of  danger,  and  he  had  almost 
as  much  dislike  of  taking  a  cold  hath  in  the  tub 
in  his  house.  Hot  water  he  did  not  mind.  He 
could  remember  a  time  in  his  childhood  when  he 
had  no  such  aversion,  but  enjoyed  going  in  swim- 
ming  with  the  rest  of  the  boys. 

The  explanation  of  this  antipathy  is  to  be  found 
in  what  is  known  as  the  ''Small  Penis  Complex.'' 
Little  boys,  of  say  four  or  five  years  of  age,  when 


186     MORBID  FEARS  AND  COMPULSIONS 

passing  through  the  period  of  sexual  investiga- 
tioiiy  are  often  profoundly  impressed  with  the  dif- 
ference in  size  between  their  own  organs  and 
those  of  grown  men,  the  older  brother  or  the 
father.  From  these  comparisons  arises  a  feeling 
of  envy  and  jealousy  and  also  a  sense  of  inf  erior- 
ity,  and  thifi  forms  a  nucleus  for  a  complex  which 
grows  and  persists  long  after  the  impressions 
with  which  it  started  have  faded  from  conscious 
memory. 

It  is  a  common  experience  for  a  person  who  as 
an  adult  revisits  for  the  first  time  some  place  in 
which  he  lived  when  a  small  child,  to  be  much  as- 
tonished to  see  how  much  smaller  are  the  rooms 
and  buildings  and  how  much  shorter  are  the  dis- 
tances, than  he  had  remembered  them.  This  is 
paralleled  in  the  formation  of  the  small  penis  com- 
plex. The  memory  impressions  of  the  adult  or- 
gans with  which  the  little  boy  first  compared  his 
own  keep  in  the  Unconscious  the  original  ratio 
of  bigness,  so  that  despite  later  comparisons  in 
adolescence  or  adult  life,  which  logically  should 
serve  to  dispel  the  original  sense  of  genital  infe- 
riority, it  nevertheless  persists.  It  is  as  if  these 
old  memory  impressions,  which  became  progres- 
sively magnified  through  the  period  of  growth  and 
so  preserved  their  original  ratio,  remained  as  the 
final  criteria  of  comparison.  Naturally  the  per- 
son may  be  conscious  only  of  the  feeling  pf  in- 
feriority and  through  various  defenses  more  or 
less  escape  awareness  of  the  idea  that  this  has  a 
genital  basis.  Thus  the  person  who  unconsci- 
ously projects  to  the  female  his  own  high  estima- 


DEFENSE  MECHANISMS  187 

tion  of  the  significance  of  the  size  of  the  penis  is 
apt  to  be  backward  with  women,  and  to  feel  that 
he  has  little  sexual  desire,  the  real  reason  being 
that  he  fears  revealing  to  the  woman  the  (often 
purely  imaginary)  smallness  of  his  genitals. 

This  patient's  aversion  to  swimming  had  some- 
what this  origin.  Some  of  his  early  painful  com- 
parisons were  made  at  the  country  swimming 
hole  where  he  and  the  rest  of  the  youths  of  the 
community  were  wont  to  bathe  in  a  state  of  na- 
ture. It  did  happen  that  he  matured  rather 
slowly,  and  most  of  the  boys  of  his  age  developed 
genital  hair  and  the  other  signs  of  sexual  matur- 
ity before  he  did.  He  was  painfully  conscious 
that  their  organs  were  larger  than  his;  and  par- 
ticularly so  when  he  had  been  in  the  water,  the 
coldness  of  which  caused  his  penis  to  shrink  into 
almost  complete  obscurity.  As  may  easily  be 
seen,  swimming  or  cold  bathing  tended  in  later 
life  to  stimulate  the  small-penis  complex  through 
reviving  these  old  memories,  and  thus  threatened 
to  bring  into  his  consciousness,  despite  his  de- 
fenses, ideas  and  affects  that  were  very  painful 
to  him.  As  a  defense  his  aversion  or  resistance 
to  the  complex  was  then  transferred  to  appear  as 
an  aversion  to  bathing  (i.  e.  to  a  stimulus  of  that 
complex)  a  mechanism  much  the  same  as  that,  by 
which  as  we  shall  see  later,  some  of  the  symptoms 
of  anxiety  hysteria  are  formed. 

Another  and  very  familiar  defense  against  a 
sense  of  guilt  is  exemplified  by  the  common  wash- 
ing compulsions  or  ceremonials.  A  sense  of 
moral  impurity  or  undeanness  of  whatever  origin 


188    MORBID  FEARS  AND  COMPULSIONS 

is  replaced  by  the  notion  of  physical  tmcleanness 
or  defilement,  which  the  patient  then  seeks  to  get 
rid  of  by  continual  washing  and  scrubbing. 

Even  more  common,  though  less  often  recog- 
nized, is  a  certain  feverish  devotion  to  religion  or 
to  church  or  charitable  work.  In  women  par- 
ticularly this  is  a  very  common  defense  against  a 
sense  of  guilt  arising  from  the  masturbation  con- 
flict. Feeling  herself  to  be  **bad*'  the  patient  de- 
votes herself  to  those  activities  which  because  of 
their  nature  tend  to  give  her  a  feeling  that  she  is 
''good,''  which  then  serves  as  an  antidote  for  her 
inculpatory  affects. 

StUl  another  very  common  defense  phenomenon 
is  that  of  finding  fault  with  others  for  shortcom- 
ings of  which  one  is  possessed  oneself,  though  un- 
willing to  admit  it.  It  is  as  if  one  were  making 
an  effort  to  bring  those  about  him  down  to  the 
same  level  where  he  feels  himself  to  be.  A  num- 
ber of  the  examples  which  have  been  given  to  illus- 
trate other  points  are  at  the  same  time  instances 
of  this  mechanism.  For  instance  the  woman  who 
was  continually  accusing  her  husband  of  infidelity 
was  really  at  the  same  time  defending  herself 
against  the  guilty  sense  of  having  been  unfaith- 
fid  to  him  in  her  thoughts.  The  man  who  felt 
that  rich  girls  put  the  things  that  money  could 
buy  before  considerations  of  love  and  sentiment 
was  only  accusing  them  of  what  he  vaguely  felt 
himself  also  to  be  guilty.  In  the  case  described 
in  Chapter  VII  we  shall  find  some  excellent  ex- 
amples of  this  form  of  defense.  I  may  also  men- 
tion one  from  my  own  personal  experience.    I 


DEFENSE  MECHANISMS  189 

> 

found  at  one  time  that  I  was  becoming  very  im- 
patient at  what  I  was  pleased  in  my  own  mind  to 
call  the  stupidity  displayed  by  a  woman  I  had  been 
analyzing  for  some  time  with  very  meager  suc- 
cess. If,  for  instance,  I  explained  something  to 
her,  and,  as  often  was  the  case,  she  did  not  grasp 
my  meaning,  or  asked  me  to  explain  the  thing 
over  again,  I  would  feel  exasperated  at  her  dull- 
ness in  failing  to  comprehend  what  seemed  to  me 
very  simple.  On  one  or  two  occasions  when  she 
had  made  some  feeble  complaint  to  the  effect  that 
fihe  was  not  improving  very  much,  I  had  felt  an 
unreasonable  impulse  to  tell  her  that  a  person 
with  no  brains  need  not  expect  to  get  well  rapidly 
by  a  method  that  required  xmderstanding. 

It  is  true  that  this  patient  was  not  remarkably 
intelligent,  yet,  as  it  at  length  occurred  to  me,  I 
was  at  the  same  time  analyzing  another  young 
woman  who  was  no  more  intelligent  than  she,  but 
toward  whom  I  never  felt  irritable,  and  if  she 
asked  me  to  repeat  or  clarify  an  explanation  I  did 
it  with  complete  patience  and  good  nature.  The 
first  patient  was  not,  as  I  had  sometimes  told -my- 
self,  too  stupid  to  be  analyzed,  for  as  I  knew,  once 
I  stopped  to  think  of  it,  I  had  had  good  success 
with  other  patients  no  more  intelligent  than  she, 
and  in  some  instances  her  mental  inferiors. 
Finally  I  realized  that  the  reason  I  felt  irritated 
with  her,  and  in  my  own  mind  called  her  a  fool, 
was  that  the  circumstances  were  such  that  she 
was  making  me  feel  that  I  was  one. 

The  reasons  for  this  were  as  follows.  She  was 
referred  to  me  by  a  certain  doctor  who  had  never 


190    MORBID  FEARS  AND  COMPULSIONS 

sent  me  any  cases  before  and  who  I  knew  from  con- 
versations I  had  had  with  him  was  rather  skep- 
tical as  to  the  value  of  psychoanalysis.  He  had 
been  rather  interested  in  the  case  of  this  patient 
and  had  for  a  long  time  tried  to  care  her  himself 
by  various  physical  means.  I  suspected  that  one 
reason  he  sent  her  to  me  was  that  he  had  at  last 
gotten  tired  of  her  continued  complainings,  more 
than  that  he  had  any  deep  faith  in  my  being  able 
to  do  her  any  good.  When  I  saw  the  patient  for 
the  first  time  I  thought  the  case  would  not  be  a 
very  difficult  one,  and  I  was  malicious  enough  to 
take  pleasure  in  the  thought  that  when  I  did  cure 
her,  I  would  wind  up  the  thoroughly  good-natured 
arguments  I  had  had  with  him  about  psycho- 
analysis by  the  triumphant  statement  that  it  had 
succeeded  when  his  methods,  carried  out  for  even 
a  longer  time,  had  met  with  absolute  failure.  I 
knew  also  that  if  I  did  succeed  with  this  case,  the 
doctor  in  question,  who  has  an  excellent  practice 
among  well  to  do  people,  would  send  me  other  pa- 
tients, a  consideration  to  which  at  that  time  at 
least  I  was  anything  but  indifferent.  For  these 
reasons  I  accepted  the  woman  for  analysis  even 
though,  as  I  knew,  I  would  have  to  treat  her  for 
a  smaller  fee  than  I  was  in  the  habit  of  charging. 
But  after  the  analysis  was  begun  I  found  that  the 
case  was  really  a  much  more  difficult  one  than  I 
had  expected,  and  that  there  was  a  certain  amount 
of  danger  that  instead  of  my  being  able  to  report 
triumphantly  to  my  friend  that  I  had  succeeded 
where  he  had  failed  and  to  enjoy  the  rewards  of 
this  success  in  the  shape  of  other  patients  referred 


DEFENSE  MECHANISMS  191 

by  him,  he  would  be  able  to  crow  over  me  and  to 
say  that  the  method  I  had  so  stoutly  defended  was 
no  better  in  results  than  his  own.  In  addition 
to  this  I  would  have  to  reflect  that  instead  of  my 
acquaintance  with  this  patient  reacting  to  my 
profit,  in  the  form  of  new  cases  referred  by  him,  I 
would  have  nothing  to  compensate  me  for  the 
time  I  had  spent  on  her  but  a  fee  so  small  as  to 
constitute  no  reward  at  all.  Thus  though  all 
these  facts  were  not  ever  continuously  before  my 
mind,  nevertheless  I  had  some  basis  for  feeling 
that  I  was  a  fool  or  had  made  a  fool  of  myself, 
and  I  could  not  see  the  patient  without  being,  so 
to  speak,  xmconsciously  reminded  of  them.  The 
irritation  I  experienced  was  really  not  so  much 
a  product  of  thoughts  about  her  stupidity  as  about 
my  own.  With  the  other  patients  who  were 
equally  or  even  more  slow  of  comprehension  I  had 
felt  no  irritation,  for  there  was  nothing  in  the 
situation  to  injure  my  self-esteem.  I  may  add 
that  once  I  had  faced  these  facts  which  I  was  in- 
voluntarily trying  to  escape  from,  I  was  able  to 
dispel  my  sense  of  irritation  with  the  woman  and 
to  make  of  the  analysis  a  fairly  complete  success. 
A  mechanism  of  disguise  or  defense  which  is 
most  commonly  observed  in  the  compulsion  neuro- 
sis is  that  by  generalization.  Feelings  which  in 
the  patient's  consciousness  are  attached  to  a  class 
or  group  really  refer  in  the  unconscious  to  a  spe- 
cial one  of  its  members.  This  is  exemplified  by 
the  case  of  the  young  woman  who  had  an  antipathy 
to  all  blond,  blue-eyed  men,  which  was  really 
founded  on  repressed  wishes  concerning  one  par- 


192    MORBID  FEARS  AND  COMPULSIONS 

tioular  man  of  that  type.  The  woman  who  was 
converted  to  Christian  Science  and  ''hated"  aU 
doctors  concealed  within  this  generalization  mixed 
feelings  of  love  and  resentment  toward  one  par- 
ticular member  of  the  profession.  Brill  reports 
the  case  of  a  Hebrew  who  suffered  from  the  obses- 
sive idea  that  the  Gentiles  were  going  to  kill  all 
the  Jews.^  This  obsession  had  origin  in  a  death 
wish  against  one  particular  Jew,  namely,  the  pa- 
tient's father. 

(f)    TBANSFBBBlirOB 

'  Among  the  phenomena  occurring  under  the 
head  of  Displacement  we  became  acquainted  with 
a  form  of  identification  which  I  suggested  might 
be  called  subjective  or  introjective  identification. 
This  was  to  distinguish  it  from  the  other  and  even 
more  important  variety  which  we  might  designate 
as  objective  identification,  but  which  we  shall  con- 
sider xmder  the  more  commonly  used  term  of 
Transference. 

In  subjective  identification,  as  was  said,  the  ego 
is  broadened  to  include  within  it  other  persons  or 
objects  that  are  really  external.  In  objective 
identification,  or  transference,  the  individual,  in- 
stead of  identifying  external  objects  or  persons 
with  himself,  identifies  them  with  each  other,  and 
behaves  or  feels  toward  one  in  a  way  that  is  ap- 
propriate to,  and  conditioned  by,  experiences  and 
impressions  which  really  refer  to  the  other.  The 
subject  is  usually  not  conscious  of  the  existence 

1  "PVychoonalyaiB''— Chapter  on  tlie  Compulsio&  KeiuoiiB. 


TRANSFEEENOE  193 

of  the  identification  nor  as  a  mle  does  he  remem- 
ber at  all  completely  the  experiences  from  which 
the  transferred  feelings  really  arise. 

To  make  clear  what  is  meant  by  transference 
I  will  give  an  instance  of  it  from  my  own  life.  I 
was  at  one  time  confronted  with  a  very  difficult 
problem  in  my  personal  affairs  which  I  soon  felt 
was  too  mnch  for  me  to  solve  alone  and  would 
necessitate  my  seeking  some  help  and  advice. 
There  were  among  my  friends  three  men  with 
whom  I  was  very  intimate,  to  any  one  of  whom  I 
might  have  gone  in  this  emergency  with  every  as- 
surance of  receiving  full  cooperation  and  most 
valuable  advice.  Instead  of  doing  this,  I  went  to 
a  fourth  man  about  whom,  though  I  had  some 
pleasant  acquaintance  with  him,  I  really  knew 
very  little,  and  whom  I  could  hardly  regard  as  a 
friend.  I  had  in  fact  no  logical  grounds  for  be- 
lieving that  this  man,  whom  we  may  call  X.  was 
really  qualified  to  give  me  the  help  I  needed,  or 
that  I  could  safely  trust  him  with  full  knowledge 
of  the  situation.  I  now  know  that  I  could  not  have 
chosen  a  better  person,  yet  for  all  the  informa- 
tion at  my  command  then,  he  might  very  well  have 
been  the  worst. 

When  I  went  to  him  I  had  no  realization  that 
I  was  doing  a  very  illogical  and  possibly  unsafe 
thing.  Such  a  possibility  had  not  occurred  to  me 
nor  did  I  think  there  was  anything  peculiar  in 
my  choosing  him  in  place  of  some  one  of  the  three 
other  men  who,  under  the  circumstances,  were 
the  logical  persons  for  me  to  go  to,  until  my  wife 


194    MORBID  FEAES  AND  COMPULSIONS 

expressed  her  surprise  at  what  I  had  done.  Then 
all  at  once  I  realized  how  strange  my  choice  had 
been. 

As  soon  as  I  asked  myself  the  reason,  it  came 
to  my  mind  that  during  the  night  preceding  the 
day  I  went  to  see  X  I  had  had  a  dream  in  wliich 
appeared  certain  perplexities,  which,  I  could  read- 
ily see,  represented  the  problem  then  confronting 
me,  and  I  called  to  my  assistance  a  certain  man 
named  T.,  who  had  been  a  member  of  the  house- 
hold during  my  childhood.  It  then  at  once  be- 
came dear  to  me  why  in  my  difficulty  I  had  so 
unhesitatingly  gone  for  help  to  X  For,  as  I 
now  realized  for  the  first  time,  X.  and  T.,  though 
of  very  different  ages,  look  a  great  deal  alike.  On 
the  basis  of  this  similarity  in  appearance  I  had 
unconsciously  identified  X.  with  T.  Consequently 
I  felt  toward  X.  the  sense  of  trust  and  confidence 
that,  on  the  basis  of  childhood  experiences,  I  really 
had  reason  to  feel  toward  T.  In  short,  I  felt  and 
acted  as  if  I  were  dealing  not  with  the  relative 
stranger  X.  but  with  T.,  a  person  whom  I  could 
logically  regard  as  a  tried  and  true  friend.  In- 
cidentally it  may  be  remarked  that  X.  and  T., 
though  alike  in  appearance  and,  as  I  can  now  say, 
in  being  equally  dependable  friends  to  me,  are,  in 
most  respects,  about  as  unlike  as  two  persons  well 
could  be. 

My  failure  to  go  with  my  problem  to  any  one 
of  the  three  intimate  friends  I  have  mentioned 
also  appears  to  be,  in  part  at  least,  the  result  of  a 
transference  involving  them.  When  as  a  little 
boy  I  got  into  difficulties  and  needed  some  help. 


TRANSPEEENCE  195 

I  always  went  by  preference  to  T.  rather  than  to 
my  father  or  grandfather  (in  whose  home  I  spent 
a  large  part  of  my  boyhood)  not  only  because  I 
had  the  greatest  confidence  in  T.  's  ability  to  help 
me  but  because  I  was  sure  that  he  would  be  toler- 
ant and  sympathetic,  as  at  times  the  others  were 
not.  If,  as  was  usually  the  case,  the  trouble  I 
got  into  was  a  result  of  some  deviltry  or  mistake 
of  mine,  T.  would  be  just  as  good-natured  about 
helping  me  out  of  it  as  if  I  had  been  perfectly 
blameless.  With  my  father  or  grandfather,  how- 
ever, I  ran  a  certain  danger  of  being  scolded  and 
told  that  if  through  my  own  fault  I  got  into 
trouble,  it  was  only  what  Ivdeserved.  The  diflB- 
culties  which  led  me  to  consult  X.  would  not  have 
arisen  had  I  not  made  certain  mistakes  of  a  char- 
acter not  calculated  to  enhance  my  self-esteem. 
My  three  friends,  who  were  the  logical  persons 
of  whom  to  seek  advice,  as  my  father  and  grand- 
father had  been  in  my  childhood,  were,  it  so  hap- 
pened, the  sort  of  persons  who,  whatever  mis- 
takes they  might  make,  would  surely  have  avoided 
the  kind  which  at  that  time  was  the  cause  of  my 
perplexities.  In  this  respect  I  could  identify  them 
with  my  father  and  grandfather  who  were  entirely 
superior  to  the  deviltries  responsible  for  most 
of  my  childhood  worries.  For  this  reason  I  ex- 
pected (very  unjustly,  I  think)  that  my  friends 
would  blame  me  for  the  mistakes  I  had  made  as, 
without  being  quite  ready  to  a^mit  it,  I  was  then 
blaming  myself.  I  projected  to  them  my  own  self- 
criticism,  which  was  originally  parental  criticism. 
My  behavior  and  feelings  throughout  are  thus 


196    MORBID  FEARS  AND  COMPULSIONS 

seen  to  be  a  repetition  of  reactions  carried  out 
many  times  in  childhood  and  were  conditioned  al- 
most entirely  by  experiences  of  the  past  and  only 
partiy  by  the  actual  facts  of  the  present.  That  I 
was  so  fortunate  as  to  find  in  X  an  equaUy  de- 
pendable ally  as  in  my  boyhood  T.  had  been  was 
simply  a  stroke  of  great  good  luck. 

The  point  in  this  example  to  which  I  wish  espe- 
cially to  call  attention  is  that  the  practically  com- 
plete transference  and  identification  had  such  a 
really  insignificant  basis,  a  not  even  striking  simi- 
larity in  appearance  between  the  two  men.  Bat 
there  is  nothing  unique  about  this.  Psycho- 
analysis furnishes  multitudes  of  examples  of 
transference  of  even  the  profoundest  of  feeling, 
where  the  features  common  to  the  two  persons 
identified  are  of  the  most  trivial  character — ^the 
manner  of  holding  a  cigar,  the  color  of  the  hair, 
some  little  mannerism  or  trick  of  speech,  etc 

That  such  insignificant  stimuli  should  have  at 
times  the  power  to  produce  such  profound  and 
apparently  disproportionate  reactions  seems  at 
first  thought  hardly  credible,  or  at  least  without 
parallel  with  anything  else  within  the  sphere  of 
our  observation.  Nevertheless  there  is  a  parallel 
to  be  found  (perhaps  it  is  really  the  same  thing) 
in  certain  phenomena  that  have  been  observed 
particularly  by  students  of  animal  behavior. 
Pawlow,  Watson,  Lashley  and  others,*  have  shown 

1  Pawlow — ^^'Investigation  of  the  Higher  Nerrous  Fonctions." 
Watson— "The  Place  of  the  Conditioned  Reflex  in  Pflychology" 

— Peycholoffical  Review,  VoL  XXIII,  No.  2. 
Lashley — ^"Human  Salivary  Reflex  and  its  Use  in  Psychology** 

— P^yohologioal  Review,  VoL  VII,  No.  6. 


TRANSPEEENCB  197 

that  when  the  primary  stinmlos  of  a  motor  or 
secretory  reflex  is  associated  a  number  of  times 
with  an  indifferent  stimulus,  then  this  indifferent 
stimulus  alone  may  have  the  power  of  exciting  the 
whole  efferent  part  of  the  reaction.  Let  us  con- 
sider an  example.  The  sight  of  food  is  a  stimulus 
which  normally  excites  the  flow  of  gastric  juice  in 
the  dog.  Now  suppose  that  for  a  period  a  bell 
is  rung  in  a  dog's  hearing  each  time  just  before 
food  is  shown  him  and  he  is  fed.  When  at  length 
he  has  sufficiently  associated  this  really  indiffer- 
ent stimulus  with  the  appearing  of  the  food,  then 
the  ringing  of  the  bell  alone  will  be  sufficient  to 
activate  the  efferent  paths  constituting  the 
^' motor  pattern"  and  produce  a  pouring  out  of 
gastric  juice.  This  is  known  as  a  ^  ^  conditioned  re- 
flex."  The  principle  holds  good  not  only  for  sec- 
retory reflexes  but  also  for  affective  and  appar- 
ently for  motile  responses  as  well. 

These  observations  that  a  small  and  indiffer- 
ent part  of  the  stimuli  corresponding  to  an  orig- 
inal ^^ sensory  pattern"  gain  through  temporal  as- 
sociation the  power  of  exciting  the  whole  motor 
pattern  and  efferent  discharge  are  perfectly  par- 
alleled by  and,  to  my  mind,  identical  with  what 
in  human  beings  we  call  transference.  In  the  ex- 
ample of  transference  I  have  cited,  my  feelings 
and  behavior  toward  X.  really  represented  a  sort 
of  ^^conditioned  reflex."  My  action  and  my  af- 
fective state  were  really  produced  by  the  excita- 
tion of  an  old  efferent  pattern  marked  out  in  my 
childhood  by  contact  with  T.  That  which  excited 
this  pattern  was  the  relatively  unimportant  visual 


198    MORBID  PBAES  AND  COMPULSIONS 

stimuli  corresponding  to  those  features  in  the  ap- 
pearance of  X.  which,  though  I  was  not  conscious 
of  it,  were  reminiscent  of  T.  They  were  thus  a 
small  and  indifferent  portion  of  what  corresponded 
to  the  original  sensory  ]>attem.  The  fact  then 
that  even  trivial  similarities  may  serve  to  produce 
apparently  disproportionate  affective  transfer- 
ence is  not  a  phenomenon  really  unique  and  with- 
out parallel  hut  rather  a  manifestation  of  some- 
thing fundamental  in  animal  reaction. 

We  may  now  ask  how  and  when  those  motor 
patterns  are  formed  which,  when  excited  hy  stim- 
uli from  new  objects,  produce  the  reactions  called 
transference.  What  is  the  source  of  that  which  is 
transferred?  We  may  answer  that  the  most  im- 
portant of  these  patterns  are  formed  in  childhood, 
usually  before  the  end  of  the  sixth  year,  and  that 
the  first  source  of  the  affects  transf erre^d  is  to  be 
found  in  the  relations  of  the  child  to  his  parents 
and  to  the  other  persons  constituting  his  early  en- 
vironment. This  brings  us  to  a  matter  to  which 
brief  reference  was  made  in  the  first  chapter  but 
which  we  must  now  take  up  in  considerable  detail, 
namely  the  formation  of  those  important  constel- 
lations known  as  the  (Edipus  and  the  Electra  com- 
plexes, as  well  as  those  usually  less  significant 
ones  which  refer  to  the  brother  or  sister. 

To  this  end  I  can  do  no  better  than  to  quote  di- 
rectly from  Freud.^  As  he  has  boldly  stated,  a 
sexual  preference  becomes  active  at  a  very  early 

1  The  paragraphs  here  quoted  are  from  Freud's  ''Interpretation 
of  Dreams/'  Chapter  V.  I  have  made  some  ehanges  in  their 
original  order. 


TRANSFEBENCE  199 

period.  ^  *  The  boy  regards  the  father  as  a  rival  in 
love ;  the  girl  takes  the  same  attitude  toward  the 
mother,  a  rival  by  getting  rid  of  whom  she  can- 
not but  profit/' 

^'Before  rejecting  this  idea  as  monstrous,  let 
the  reader  consider  the  actual  relations  between 
parents  and  children.  What  the  requirements  of 
culture  and  piety  demand  of  this  relation  must 
be  distinguished  from  what  daily  observation 
shows  us  to  be  the  fact.  More  than  one  cause  for 
hostile  feeling  is  concealed  within  the  relations 
between  parents  and  children;  the  conditions 
necessary  for  the  actuation  of  wishes  which  can- 
not exist  in  the  presence  of  the  censor  are  most 
abundantly  provided.  Let  us  dwell  at  first  upon 
the  relation  between  father  and  son.  I  believe 
that  the  sanctity  which  we  have  ascribed  to  the  in- 
junction of  the  decalogue  dulls  our  perception  of 
reality.  Perhaps  we  hardly  dare  to  notice  that 
the  greater  part  of  humanity  neglects  to  obey  the 
fifth  commandment.  In  the  lowest  as  well  as  in 
the  highest  strata  of  human  society,  piety  towards 
parents  is  in  the  habit  of  receding  before  other 
interests.  The  obscure  reports  which  have  come 
to  lis  in  mythology  and  legend  from  the  primeval 
ages  of  human  society  give  us  an  unpleasant  idea 
of  the  power  of  the  father  and  the  ruthlessness 
with  which  it  was  used.  Kronos  devours  his  chil- 
dren as  the  wild  boar  devours  the  brood  of  the 
sow;  Zeus  emasculates  his  father  and  takes  his 
place  as  a  ruler.  The  more  despotically  the  father 
ruled  in  the  ancient  family,  the  more  must  the 
son  have  taken  the  position  of  an  enemy,  and  the 


200    MOBBID  FEABS  AND  COMPULSIONS 

greater  must  have  been  his  impatience,  as  desig- 
nated successor,  to  obtain  the  mastery  himself 
after  his  father 's  deaths  Even  in  onr  own  middle- 
class  family  the  father  is  accostomed  to  aid  the 
development  of  the  germ  of  hatred  which  nataraUy 
belongs  to  the  paternal  relation  by  refusing  the 
son  the  disposal  of  his  own  destiny,  or  the  means 
necessary  for  this.  A  physician  often  has  oc- 
casion to  notice  that  the  son's  grief  at  the  loss 
of  his  father  cannot  suppress  his  satisfaction  at 
the  liberty  which  he  has  at  last  obtained.  Every 
father  frantically  holds  on  to  whatever  of  the 
sadly  antiquated  potestas  patris  still  remains  in 
the  society  of  to-day,  and  every  poet  who,  like  Ib- 
sen, puts  the  ancient  strife  between  the  father  and 
son  in  the  foreground  of  his  jSction  is  sure  of  his 
effect.  The  causes  of  conflict  between  mother  and 
daughter  arise  when  the  daughter  grows  up  and 
finds  a  guardian  in  her  mother,  while  she  desires 
sexual  freedom,  and  when,  on  the  other  hand,  the 
mother  has  been  warned  by  the  budding  beauty 
of  her  daughter  that  the  time  has  come  for  her 
to  renounce  sexual  claims.  All  these  conditions 
are  notorious  and  open  to  every  one's  inspec- 
tion." ^ 

iH.  G.  Welle  in  ''Ann  Veronica"  lias  given  ezpreesion  to  the 
father  complex  in  the  following  words  of  hie  character  Gapes: 
"1  don't  believe  there  is  any  strong  natural  aJffection  between 
parents  and  growing  up  children.  There  was  not,  I  know,  be- 
tween myself  and  my  father — ^I  bored  him.  I  hated  him.  I 
suppose  that  shocks  one's  ideas.  It  is  trua  There  are  senti* 
mental  and  traditional  deferences  and  reverences,  I  know,  be- 
tween father  and  son,  but  that  is  just  e3cactly  what  prevents  the 
developing  of  an  easy  friendship.  Father-worehiping  sons  are 
abnormal — ^and  they  are  no  good.  .  .  ." 


TRANSFEEENCE  201 

'^It  is  found  that  the  sexual  wishes  of  the  child 
(in  so  far  as  they  deserve  this  designation  in  their 
embryonic  state)  awaken  at  a  very  early  period, 
and  that  the  first  inclinations  of  the  girl  are  di- 
rected towards  the  father,  and  the  first  childish 
cravings  of  the  boy  towards  the  mother.  The 
father  thus  becomes  an  annoying  competitor  for 
the  boy,  as  the  mother  does  for  the  girl,  smd  we 
have  already  shown  in  the  case  of  brothers  and 
sisters  how  little  it  takes  for  this  feeling  to  lead 
the  child  to  the  death-wish.  Sexual  selection,  as  a 
rule,  early  becomes  evident  in  the  parents;  it  is 
a  natural  tendency  for  the  father  to  indulge  the 
little  daughter,  and  for  the  mother  to  take  the 
part  of  the  sons,  while  both  work  earnestly  for  the 
education  of  the  little  ones  when  the  magic  of  sex 
does  not  prejudice  their  judgment.  The  child  is 
very  well  aware  of  any  partiality,  and  resists  that 
member  of  the  parental  couple  who  discourages  it. 
To  find  love  in  a  grown  up  person  is  for  the  child 
not  only  the  satisfaction  of  a  particular  craving, 
but  also  means  that  the  child's  will  is  to  be  yielded 
to  in  other  respects.  Thus  the  child  obeys  its  own 
sexual  impulse,  and  at  the  same  time  reenforces 
the  feeling  which  proceeds  from  the  parents,  if  it 
makes  a  selection  among  the  parents  that  cor- 
responds to  theirs. 

^^Most  of  the  signs  of  Hiese  infantile  inclinations 
are  usually  overlooked ;  some  of  them  may  be  ob- 
served even  after  the  first  years  of  childhood. 
An  eight-year-old  girl  of  my  acquaintance,  when 
her  mother  is  called  from  the  table,  takes  advan- 
tage of  the  opportunity  to  proclaim  herself  her 


202    MOEBID  FEAES  AND  COMPULSIONS 

snocessor.  ^Now  I  shall  be  Mamma;  Charles, 
do  you  want  some  more  vegetables!  Have  some, 
I  beg  you/  etc.  A  particularly  gifted  and  viva- 
cious girl  not  yet  four  years  old,  with  whom  this 
bit  of  child  psychology  is  unusually  transparent, 
says  outright:  ^Now  mother  can  go  away;  then 
father  must  marry  me  and  I  shall  be  his  wife.' 
Nor  does  this  wish  by  any  means  exclude  from 
child  life  the  possibility  that  the  child  may  love 
her  mother  affectionately.  If  the  little  boy  is  al- 
lowed to  sleep  at  his  mother's  side  whenever  his 
father  goes  on  a  journey,  and  if  after  his  father's 
return  he  must  go  back  to  the  nursery  to  a  person 
whom  he  likes  far  less,  the  wish  may  be  easily  ac- 
tuated that  his  father  may  always  be  absent,  in 
order  that  he  may  keep  his  place  next  to  his  dear, 
beautiful  mamma;  and  the  father's  death  is  ob- 
viously a  means  for  the  attainment  of  this  wish; 
for  the  child's  experience  has  taught  him  that 
^dead'  folks,  like  grandpa,  for  example,  are  al- 
ways absent ;  they  never  return. 

^^  Being  dead  means  for  the  child,  which  has 
been  spared  the  scenes  of  suffering  previous  to 
dying,  the  same  as  ^ being  gone,'  not  disturbing 
the  survivors  any  more.  The  child  does  not  dis- 
tinguish the  manner  and  means  by  which  this  ab- 
sence is  brought  about,  whether  by  traveling,  es- 
trangement or  death." 

Feelings  of  hostility  and  death-wishes  are  in- 
spired not  only  by  the  parent  of  the  opposite  sex 
but  in  the  relation  of  children  to  their  brothers 
and  sisters.  Freud  goes  on  to  say:  **I  do  not 
know  why  we  presuppose  that  it  (the  relation  of 


TRANSFERENCE  203 

brothers  and  sisters ),  must  be  a  loving  one,  since 
examples  of  brotherly  and  sisterly  enmity  among 
adults  force  themselves  upon  every  one's  experi- 
encCy  and  since  we  so  often  know  that  his  estrange- 
ment originated  even  during  childhood  or  has 
always  existed.  But  many  grown  up  people,  who 
to-day  are  tenderly  attached  to  their  brothers  and 
sisters  and  stand  by  them,  have  lived  with  them 
during  childhood  in  ahnost  uninterrupted  hostil- 
ity. The  older  child  has  ill-treated  the  younger, 
slandered  it  and  deprived  it  of  its  toys;  the 
younger  has  been  consumed  by  helpless  fury 
against  the  elder,  has  envied  it  and  feared  it,  or  its 
jSrst  impulse  towards  liberty  and  first  feelings  of 
injustice  have  been  directed  against  the  oppressor. 
The  parents  say  that  the  children  do  not  agree, 
and  caonot  find  the  reason  for  it.  It  is  not  diffi- 
cult to  see  that  the  character  even  of  a  well-be- 
haved child  is  not  what  we  wish  to  find  in  a  grown 
up  person.  The  child  is  absolutely  egotistical; 
it  feels  its  wants  acutely  and  strives  remorselessly 
to  satisfy  them,  especially  with  its  competitors, 
other  children,  and  in  the  first  instance  with  its 
brothers  and  sisters.  For  doing  this  we  do  not 
call  the  child  wicked,  we  call  it  naughty ;  it  is  not 
responsible  for  its  evil  deeds  either  in  our  judg- 
ment or  in  the  eyes  of  the  penal  law.  And  this  is 
justifiably  so ;  for  we  may  expect  that  within  this 
very  period  of  life  which  we  call  childhood,  altru- 
istic impulses  and  morality  will  come  to  life  in  the 
little  egotist,  and  that,  in  the  words  of  Meynert, 
a  secondary  ego  will  overlay  and  restrain  the 
primary  one.    It  is  true  that  morality  does  not 


204    MOBBID  FEABS  AND  COMPULSIONS 

develop  simnltaneotisly  in  all  departments^  and 
furthermore,  the  duration  of  the  unmoral  period 
of  childhood  is  of  different  length  in  different  in- 
dividuals. In  cases  where  the  development  of 
this  morality  fails  to  appear,  we  are  pleased  to 
talk  about  degeneration;  they  are  obviously  cases 
of  arrested  development. 

'^Many  persons,  then,  who  love  their  brothers 
and  sisters,  and  who  would  feel  bereaved  by  their 
decease,  have  evil  wishes  towards  them  from  earl- 
ier times  in  their  unconscious,  which  are  capable 
of  being  realized  in  the  dream.  It  is  particularly 
interesting  to  observe  little  children  up  to  three 
years  old  in  their  attitude  towards  their  brothers 
and  sisters.  So  far  the  child  has  been  the  only 
one ;  he  is  now  informed  that  the  stork  has  brought 
a  new  child.  The  younger  surveys  the  arrival, 
and  then  expresses  his  opinion  decidedly:  'The 
stork  had  better  take  it  back  again.'' 

'^I  subscribe  in  all  seriousness  to  the  opinion 
that  the  child  knows  enough  to  calculate  the  dis- 
advantage it  has  to  expect  on  account  of  the  new- 
comer. I  know  in  the  case  of  a  lady  of  my  ac« 
quaintance  who  agrees  very  well  with  a  sister  four 
years  younger  than  herself,  that  she  responded 
to  the  news  of  her  younger  sister's  arrival  with 
the  following  words;  *But  I  sha'n't  give  her  my 
red  cap  anyway.'  If  the  child  comes  to  this 
realization  only  at  a  later  time,  its  enmity  will  be 
aroused  at  that  point.  I  know  of  a  case  where  a 
girl,  not  yet  three  years  old,  tried  to  strangle  a 
suckling  in  the  cradle,  because  its  continued  pres- 
ence, she  suspected,  boded  her  no  good.    Children 


TBANSPEEENCE  205 

are  capable  of  envy  at  this  time  of  life  in  all  its 
intensity  and  distinctness.  Again,  perhaps,  the 
little  brother  or  sister  has  really  soon  disap- 
peared; the  child  has  again  drawn  the  entire  af- 
fection of  the  household  to  itself,  and  then  a  new 
child  is  sent  by  the  stork ;  is  it  then  unnatural  for 
the  favorite  to  wish  that  the  new  competitor  may 
have  the  same  fate  as  the  earlier  one,  in  order  that 
he  may  be  treated  as  well  as  he  was  before  during 
the  interval!  Of  course  this  attitude  of  the  child 
toward  the  young  infant  is  under  normal  circum- 
stances a  simple  function  of  the  difference  of  age^ 
After  a  certaia  time  the  maternal  instincts  of  the 
girl  will  be  excited  towards  the  helpless  new-bom 
child. 

<<  Feelings  of  enmity  towards  brothers  and  sis- 
ters must  occur  more  frequently  during  the  age  of 
chilhood  than  is  noted  by  the  dull  observation  of 
adults/'* 

1  Before  going  any  farther  let  us  be  perfectly  clear  about  what 
Freud  does  not  mean  by  the  above  quoted  remarks.  He  does  not 
mean  that  the  CEdipus  complex  ccmsiBts,  as  some  seem  to  think, 
merely  of  a  wish  on  the  part  of  the  four  or  five  year  old  boy  to 
have  intercourse  with  his  mother.  As  a  rule,  boys  of  that  age 
do  not  know  that  intercourse  exists  and  (except  out  of  curiosity 
or  a  desire  to  experience  everything  the  father  experienced)  prob- 
ably would  not  greatly  care  for  it  if  they  did  know.  There  are, 
however,  cases  of  more  or  less  marked  sexual  precocity  which 
present  exceptions  to  this  rule,  but  a  strong  desire  for  intercourse 
for  its  own  sake  belongs  not  to  the  infantile  but  to  the  adult 
sexuality,  and  does  not  appear  as  a  dominant  impulse  until  the 
primacy  of  the  genital  zone  is  established  and  the  sexual  synthe* 
sis  is  fairly  complete.  The  dreams  or  phantasies  of  intercourse 
with  the  mother  (oonsdous  day  phantasies  of  this  character  are 
by  no  means  uncommon  about  the  time  of  puberty  and  in  many 
instances  for  some  time  after)    are  not  manifestations  of  the 


206    MORBID  FEABS  AND  COMPULSIONS 

In  these  ways,  through  repeated  excitations  and 
discharges,  certain  reaction  patterns  are  formed 
corresponding  to  each  one  of  the  persons  impor- 
tant in  the  child's  environment.  They  are  well 
defined  and  more  or  less  permanently  fixed  by 
about  the  time  of  the  beginning  of  the  latency 
period  and  before  the  end  of  the  sixth  year. 
Their  form  or  content  depends  not  only  on  the 
nature  of  the  impressions  received  from  the  per- 
sons constituting  the  infantile  environment  but 
also  upon  the  child's  constitutional  make-up. 
These  patterns  the  individual  carries  with  him 
throughout  life  and  in  larger  or  smaller  measure 
they  serve  to  determine  the  form  or  quality  of 
his  reactions  to  all  succeeding  persons.  He  has  a 
tendency  to  repeat  in  all  later  contacts  the  modes 
of  reacting  represented  by  the  primary  efferent 
patterns.  His  feeling  or  attitude  to  any  new  per- 
son is  in  part  determined  independently  of  the 

CEdipuB  complex  in  the  infantile  fonn  but  with  the  addition  of 
new  contributions  from  the  beginning  adult  aextiality. 

In  the  second  place  Freud  does  not  mean,  as  again  many  have 
seemed  to  think,  that  the  little  boy's  feeling  toward  the  father 
or  the  other  children  felt  as  rivals  is  all  hostile.  6uch  a  state  of 
affairs  almost  never  exists.  There  is  always  (at  least  in  my 
experience)  love  mixed  with  the  hostility,  no  matter  how  great 
the  latter  may  be,  and  in  many  instances  the  degree  of  love  ex- 
isting  alongside  the  hate  or  jealousy  is  of  no  mean  proportions. 
Furthermore,  it  should  not  be  understood  that  a  hostility  existing 
toward  a  parent  in  childhood  is  never  to  be  replaced  by  love  in 
later  years.  In  childhood  the  father  and  the  father-imago  are 
essentially  one.  In  later  life  they  may  not  coincide  at  alL  The 
real  fathi^  may  thus  be  loved  while  the  father-imago  remains 
invested  with  the  fuU  measure  of  infantile  hate.  Mutat%9 
mutamdU  the  same  may  be  said  In  regard  to  the  mother^imago 
and  mother  love. 


TBANSFEEENCE  207 

actual  sum  of  peculiarities  or  total  make-up  of 
this  person,  but  is  also  partly  determined  by  that 
Ofne  of  the  original  sensory  patterns  with  which 
the  stimuli  proceeding  from  this  person  happen 
to  coincide. 

The  extent  to  which  the  individual's  later  reac- 
tions follow  the  old  patterns  and  the  degree  to 
which  these  patterns  are  modified  or  added  to  by 
new  impressions  and  experiences  varies  a  good 
deal  with  different  individuals.  It  may  be  said, 
however,  that  those  of  neurotic  predisposition  and 
those  who,  after  attaining  adolescence  are  kept  by 
objective  or  other  conditions  longest  under  the 
influence  of  the  family,  have  the  greatest  tend- 
ency to  repeat  in  their  feelings  and  behavior  the 
infantile  modes  of  reacting  and  to  retain  the  orig- 
inal efferent  patterns  in  the  least  modified  form. 

To  express  some  of  this  in  more  strictly  psy- 
choanalytic terms,^  there  is  formed  in  childhood  an 
^^ Imago"  corresponding  to  each  one  of  the  per- 
sons of  the  family,  and  these  imagines,  which  rep- 
resent a  precipitate  of  a  large  group  of  emotion- 
ally toned  experiences,  are  permanently  retained 
by  the  individual  in  the  Unconscious.  Upon  each 
one  is  fixed  a  varying  amount  of  the  libido  (hostile 

1 1  hope  I  need  not  apologize  for  borrowing  certain  terms  from 
the  behaviorists  to  express  strictly  psychoanalytic  ideas.  It  is 
to  the  behaviorists  rather  than  to  the  ''orthodox"  psychologists, 
that  psychoanalysis  will,  it  seems  to  me,  look  for  help  and  co- 
operation in  the  future,  and  I  would  like  to  see  the  terminology 
of  the  two  schools  interchangeable  as  far  as  possible.  The  most 
understanding  and  valuable  contribution  to  psychoanalytic  litera- 
ture yet  made  by  a  member  of  another  school  is  from  a  be- 
haviorist,  Prof.  £.  B.  Holt.     (''The  Freudian  Wish.") 


.   ■  »■«■ 


208    MORBID  PEARS  AND  COMPULSIONS 

or  tender)  which  is  not  actually  applied  to  reality, 
and  this  tends  to  become  transferred  (temporarily 
or  permanently)  to  those  persons  of  later  life  who 
can  be  fitted  into  the  infantile  imago,  and  in  such 
connection  to  discharge  itself  in  repetitions  of 
the  corresponding  infantile  reactions  in  so  far  as 
subjective  inhibitions  and  external  circumstances 
will  permit  Thus  a  man  who  as  a  child  hated  his 
father  tends  in  later  life  to  hate  in  like  manner 
those  persons,  say  his  employers,  who  have  some 
features  in  common  with  the  unconscious  father- 
imago,  often  when  these  features  are  of  them- 
selves indifferent  ones,  and  neither  they  nor  any 
others  give  logical  grounds  for  hate.  In  the  same 
way  he  chooses  his  love-objects  after  the  model  of 
the  mother.  The  more  dosely  a  woman  tends  to 
coincide  with  the  unconscious  mother  imago  the 
more  is  she  likely  to  be  loved,  while  toward  those 
who  fail  to  reciJl  the  adored  parent  he  tends  to 
remain  cold. 

It  should  perhaps  be  said  that  the  unconscious 
imago  of  father,  mother,  sister  or  brother  is  not 
necessarily  an  accurate  picture  of  the  person  in 
question.  On  the  contrary  it  is  usually  a  very  un- 
true one,  as  might  be  expected.  The  real  mother 
is  seldom  as  angelic  or  as  beautiful  as  the  boy 
of  five  thinks  her,  nor  the  father  the  cruel  and 
powerful  tyrant  he  can  appear  in  his  son's  eyes. 
But  the  fact  that  in  his  later  years  the  boy  may 
clearly  see  that  his  mother  is  not  an  angel  nor  his 
father  an  enemy  does  not  prevent  him  from  re- 
taining in  the  Unconscious  the  quite  unaltered  par- 


TEANSFEEENOE  209 

ental  imagines  formed  in  early  years.  Thus  it  is 
quite  possible  for  a  person  to  be  displaying  hostile 
reactions  to  surrogates  for  the  father  (persons  un- 
consciously identified  with  the  father  imago)  while 
with  the  real  father  he  is  the  best  of  friends.*  In 
the  normal  course  of  things  the  QSdipus  (or  Elec* 
tra)  attitude  toward  the  real  parents,  which  has 
experienced  an  amelioration  or  apparent  disap- 
pearance during  the  latency  period,  is  to  some  ex- 
tent restored  for  a  time  with  the  onset  of  sexual 
maturity,  but  then,  as  the  adolescent  gradually 
transfers  his  libido  to  objects  outside  the  fanuly, 
it  ceases  to  exist  as  such,  even  though  in  the  most 
normal  the  influence  of  the  parental  imagines  al- 
ways continues  to  play  an  important  role.  In 
neurotics  the  infantile  attitude  may  be  kept  up 
toward  the  real  parents,  even  consciously,  but  in 
any  event  the  amount  of  libido  fixed  upon  the 
parental  imagines  in  the  Unconscious  (as  distin- 
guished from  that  which  is  applied  to  real  objects 
in  the  external  world)  is  with  them  dispropor- 
tionately very  large.  The  fact  that  in  the  Uncon- 
scious the  infantile  attitude  to  the  parents  or  their 
•surrogates  persists  indefinitely  is  in  line  with 

1  Such  statements  as  that  a  patient  '^tes  his  father^  or  "is 
in  lore  with  his  mother"  have  been  used  rather  carelessly  by 
some  psychoanalytio  writers  when  it  was  not  the  real  father  or 
mother  but  the  parental  imago  that  was  meant.  Of  course  cases 
in  which  the  patient  in  every  sense  of  the  word  hates  the  real 
father  or  is  in  love  with  the  real  mother  are  not  at  all  uncommon, 
but  this  does  not  justify  us  in  failing  to  distinguish  in  our  re- 
ports whether  it  is  the  real  parent  or  the  distorted  subjective 
conception  of  the  parent  (the  parental  imago)  which  in  any  given 
case  is  hated  or  loved. 


210    MORBID  FEARS  AND  COMPULSIONS 

what  was  said  in  the  first  chapter  in  regard  to 
the  processes  of  the  Unconscious  being  nnoriented 
as  to  time  and  reality. 

Imagines  of  later  persons  as  well  as  those  of 
the  infantile  environment  may  also  be  formed  and 
retained  in  the  Unconscious  as  the  basis  for  still 
other  identifications  and  transferences.  For  ex- 
ample, as  described  in  Freud's  ^'Bruchstiicke  einer 
Hysterie  Analyse"  (Sammlung  kleiner  Schriften 
zur  Neurosenlehre,  Bd.  11)  his  patient  Dora  iden- 
tified Freud  with  Herr  K.,  the  man  she  had  loved, 
and  applied  to  the  former  certain  sentimental 
and  revengeful  impulses  which  really  referred 
to  the  latter.  In  succeeding  chapters  of  the  pres- 
ent book  we  shall  meet  with  similar  examples,  for 
instance  in  the  case  of  Miss  S.  (Chapter  IX)  and 
in  the  case  of  Stella  (Chapter  VII).  It  may  be 
said,  however,  that,  as  a  general  if  not  always 
demonstrable  fact,  these  transferences  from  one 
to  another  person  of  adult  life  are  really  in  the 
last  analysis  transferences  from  the  infantile  im- 
agines. Thus,  had  the  work  been  carried  far 
enough,  it  might  have  been  dearly  revealed  that 
Dora's  love  and  revenge  impulses  for  Herr  K. 
which  she  transferred  to  Freud,  had  earlier  been 
similar  feelings  for  her  father  which  she  had 
transferred  to  Herr  K. 

In  regard  to  the  fidelity  which  our  reactions 
bear  to  early  impressions  it  might  be  said  that 
we  resemble  certain  primitive  races  such  as  the 
Bushmen  of  Australia,  who  have  practically  no 
abstract  words  or  ideas.  In  place  of  such  a  word 
as  hard  the  savage  thinks  like  a  stone;  long  is 


MOTHER  COMPLEX  211 

Wee  a  fiver;  blue  is  like  the  sky.  In  the  same  way, 
to  our  unconscious  thinking,  Miss  Jones  is  not 
beautifid,  amiable  or  sympathetic,  nor  Mr.  Smith 
overbearing,  quick  tempered  or  in  the  way,  but 
like  Mother,  like  Father,  or  like  brother  or  sister, 
as  the  case  may  be.  But  in  a  certain  sense  neu- 
rotics, and  to  a  less  extent  all  of  us,  exceed  the 
limits  indicated  by  this  feature  of  savage  thought 
and  language.  The  savage's  idea  of  a  path 
which  is  long  may  be  like  a  river  but  he  does  not 
act  toward  the  path  as  if  it  were  a  river,  and, 
for  instance,  try  to  swim  in  it.  Yet  the  qualities 
such  as  beauty  in  a  woman  or  overbearingnesd  in 
a  man  which  to  the  Unconscious  are  like  Mother 
or  like  Father,  lead  us,  within  certain  limits,  to 
feel,  and  even  to  act,  as  if  the  case  were  not  one 
merely  of  like  but,  more  or  less  completely,  of  is. 
For  exampje,  a  wealthy  yoxmg  man  became  in- 
fatuated with  a  divorcee  considerably  older  than 
himself,  who,  as  was  clearly  apparent  to  every 
one  but  him,  was  a  thoroughly  unscrupulous  ad- 
venturess. But  in  his  eyes  she  was  the  purest, 
truest  and  best  of  all  women.  His  friends  who 
tried  to  save  him  from  her  clutches  by  bringing 
forth  evidence  from  her  past  record  or  present 
behavior  to  show  that  she  was  absolutely  mercen- 
ary, were  to  his  mind  but  slanderers  made  malici- 
ous through  envy  of  his  love.  He  confided  to 
her  all  his  intimate  affairs,  allowed  her  to  ex- 
tract large  sums  of  money  from  him  on  the  flimsi- 
est of  pretexts,  and  put  himself  absolutely  in  her 
power  with  childlike  trust  in  her  being  heart  and 
Boul  devoted  to  him.    The  explanation  is  that 


212    MORBID  FEARS  AND  COMPULSIONS 

certain  features  of  this  woman,  her  being  older, 
having  belonged  to  another,  her  treating  him  like 
a  small  boy,  these,  together  with  some  vagae 
similarities  in  appearance,  caused  an  nnconsdons 
identification  with  his  mother  {a,  sense  not  merely 
of  i^  like  but  of  t^),  whereupon  the  whole  motor 
pattern  corresponding  to  the  mother-imago  was 
brought  into  play,  and  he  experienced  toward  her 
all  the  feelings  of  love,  trust,  and  devotion  which 
had  been  felt  toward  the  actual  mother,  but  which, 
as  any  one  but  himself  could  clearly  see,  were 
pitifully  inappropriate  here. 

Reactions  from  the  father  complex  are  exem- 
plified in  the  case  of  a  male  patient,  an  able  and 
fairly  successful  professional  man,  of  consider- 
able wealth  and  social  standing,  who  complained 
of  often  being  overawed  by  persons  who,  in  many 
cases  his  reason  told  him,  were  really  beneath 
him.  If  a  loud  voiced  aggressive  man  made  a 
statement,  the  patient  was  impelled  to  agree  with 
him,  even  when  he  knew  the  other  to  be  wrong. 
When  a  street-car  conductor  would  shout  roughly : 
**Move  up  forward  I'*  he  would  feel  constrained, 
instantly  to  obey,  even  while  he  realized  that  per- 
haps nobody  else  in  the  car  was  paying  the  slight- 
est attention.  Once  when  on  going  to  a  hotel  he 
found  the  room  assigned  to  him  was  almost  unin- 
habitable, and  he  went  to  the  clerk  to  protest,  that 
individual's  somewhat  cold  and  insolent  glance  so 
overcame  him  that  he  instantly  abandoned  his 
purpose  and  asked  for  some  postage  stamps.  An 
agent  was  able  to  sell  him  a  rather  large  policy  of 
life  insurance,  which  he  had  not  the  slightest  de- 


FATHEE  COMPLEX  213 

sire  to  purchase,  because  the  man  had  such  a  com- 
manding presence  and  authoritative  manner  that 
the  patient  lacked  the  courage  to  say  No.  These 
are  only  a  few  of  a  great  many  instances  of  a 
similar  nature,  which  even  went  so  far  that  on 
one  occasion  he  caught  himself  saying  '^Yes,  Sir" 
to  a  waiter  whose  severe  coxmtenance  and  for- 
bidding mien  had  half  consciously  impressed 
him.  T^th  persons  more  logically  deserving  of 
respect  he  was  equally,  if  less  conspicuously,  un- 
assertive. Meanwhile  he  hated  those  persons  who 
overawed  him,  and  hated  himself  for  being  unable 
to  prevent  it. 

The  significance  of  these  reactions  is  of  course 
quite  simple.  Indications  of  authoritativeness, 
dictatorialness,  sternness  or  severity  in  another 
man  (especially  an  older  man)  produced  an  iden- 
tification with  the  father  and  caused  a  transfer- 
ence-reaction in  the  shape  of  the  mixed  feelings 
of  submissiveness,  fear  and  obedience,  and  the 
less  clearly  perceived  ones  of  hate,  rebellion  and 
antagonism,  which  were  appropriate  to  the  father 
alone.  The  rough  order  of  the  street-car  conduc- 
tor or  the  forbidding  countenance  of  the  waiter 
which  should  at  most  have  only  served  as  a  re- 
minder of  the  father  (an  i^  like  reaction),  instead 
activated  the  whole  motor  pattern  corresponding 
to  the  father  and  resulted  in  a  reaction  of  identity. 

The  feelings  belonging  to  the  father  complex 
may  be  transferred  not  only  to  logical  surrogates 
for  the  father  (the  teacher,  employer  or  any  other 
person  in  authority)  but  likewise  are  capable  of 
being  brought  into  play  by  essentially  impersonal 


2U  MORBID  FEABS  AND  COMPULSIONS 

things.  As  in  the  life  of  the  little  boy  restraint, 
control  and  punishment  are  ordinarily  repre- 
sented by  the  father,  thus  whatever  in  later  life 
restrains,  prohibits  or  threatens  ill  consequences 
may  be  xmconsciously  identified  with  the  father. 
Thus  what  was  primarily  the  rebellion  of  the  boy 
against  his  father's  authority  may  in  later  years 
be  directed  to  religion,  the  law,  convention,  etc, 
and  the  person  so  becomes  an  active  atheist,  an- 
archist or  railer  at  conventional  restraints.  Or  if 
over-compensations  have  developed,  he  may  dis- 
play the  other  extremes  of  religious  fanaticism, 
over-conscientious  and  scrupulous  obedience  to 
every  sort  of  code,  standard  or  prohibition,  or  of 
great  devotion  to  the  state  or  ruler.  One  of  my 
patients  who  belonged  in  the  category  of  compen- 
satory over-conscientiousness  well  described  him- 
self by  saying:  '^I  have  always  been  so  afraid 
of  doing  something  wrong  that  I  have  never  yet 
done  anything  righf  ^ 

Other  examples  of  objective  identification  and 
transference  are  as  follows.  A  patient  who  suf- 
fered at  times  from  psychic  impotence  and  who  as 
a  rule  seemed  to  care  little  for  women,  was  most 

iThe  cases  we  have  cited  to  illustrate  other  points  ooatain 
instances  of  transference.  For  example  the  girl  suflPering  with 
a  pain  in  her  face  had  identified  me  with  her  parents  (really 
with  her  father)  and  her  antagonism  to  me  (corresponding  to 
the  notion  that  I  was  desirous  of  breaking  up  her  lore  affair) 
was  a  transference  of  the  similar  feeling  she  had  had  for  her 
father.  Underneath  her  antagonism  was  the  affectionate  trans- 
ference, originally  the  wish  to  do  what  he  wished  in  order  to 
please  him.  The  example  of  the  man  who  would  not  submit  to 
the  tyranny  of  time-tables  shows  a  different  iraasferenoe  from 
the  father. 


MOTHER  COMPLEX  215 

attracted  by  comparatively  ignorant  servant  girls 
or  nurse  maids  older  than  himself,  and  as  a  role 
only  by  those  who  were  very  thin  and  dark.  His 
only  serious  love  affairs  were  with  such  women, 
and  in  these  relations  he  was  completely  potent 
His  preference  for  women  of  this  type  was  espe- 
cially striking,  since  he  had  always  lived  in  most 
refined  surroxmdings  and  was  a  man  of  xmusual 
intelligence  and  culture — ^in  short,  one  who  would 
be  expected  to  find  congenial  only  women  who 
possessed  cultural  and  educational  attainments 
comparable  to  his  own.  But  such  women,  though 
he  was  perfectly  capable  of  experiencing  the  great- 
est admiration,  respect  and  liking  for  them,  never 
aroused  in  him  any  sensual  emotion  or  desire  for 
physical  contact  and  caresses.  One  peculiarity 
of  his  attachment  to  the  women  who  did  sensually 
attract  him  was  that  he  was  very  jealous,  not  of 
grown  men,  but  of  the  children  xmder  their  care, 
and  quite  xmreasonably  suspected  that  some  sort 
of  sexual  practices  were  going  on. 

The  peculiarities  of  this  patient's  attitude  to- 
ward women  is  readily  explained  on  the  basis  of 
identification  and  transference.  The  patient  was 
the  oldest  of  several  children.  He  had  been  the 
favorite  of  his  mother,  a  woman  of  great  force  and 
brilliance,  as  well  as  exceptional  culture  and  refine- 
ment, who  had  lavished  upon  him  the  wealth  of 
affection  she  was  unable  to  bestow  upon  her  quar- 
relsome and  alcoholic  husband.  The  patient  was 
attached  to  his  mother  most  deeply,  and  regarded 
her  a«  the  most  wonderful,  pure  and  angelic  of 
all  the  women  that  had  ever  lived.    When  he 


216    MORBID  FBABS  AND  COMPULSIONS 

was  about  five  years  old  his  mother  was  away  for 
some  months,  leaving  her  children  in  the  charge 
of  a  nurse  who  had  for  a  long  period  been  in  the 
employ  of  the  family.  This  nurse  began  the  prac- 
tice of  having  one  of  the  children  sleep  with  her, 
usually  the  patient,  but  sometimes  one  of  the  other 
children.  He  awoke  one  morning  before  she  did, 
and  finding  that  the  bed  covers  were  thrown  back 
so  she  was  partially  exposed,  he  began  a  cautious 
investigation  of  her  genitals,  in  the  midst  of 
which  she  woke  up  and  discovered  him.  Instead 
of  scolding  him,  as  his  mother  had  done  when  on 
certain  occasions  he  had  displayed  some  sexual 
curiosity,  the  nurse  laughed  and  kissed  him,  and 
then  exposing  herself  still  further  encouraged  him 
to  go  on  with  his  investigations.  After  this  nearly 
every  morning  she  would  play  with  his  genitals, 
often  taking  them  in  her  mouth,  and  would  en- 
courage him  to  look  at  and  handle  hers.  He  took 
no  little  pleasure  in  this,  and  in  the  affection  and 
petting  he  now  received  from  her;  and  on  those 
occasions  when  she  took  one  of  the  other  children 
to  sleep  with  her,  he  was  mad  with  jealousy,  fear- 
ing that  she  might  carry  on  with  the  others  the 
same  practices  he  wished  to  be  reserved  for  him. 
The  morning  sexual  play  continued  until  after 
his  mother's  return,  when  she  somehow  discov- 
ered it,  and,  in  an  extremity  of  rage  and  horror, 
turned  the  nurse  out  of  the  house.  Her  vehement 
expressions  of  disgust  and  the  attitude  of  shrink- 
ing and  aversion  which  she  for  some  time  dis- 
played toward  her  small  son,  gave  him  the  im- 
pression that  what  had  taken  place  was  unspeak- 


MOTHER  COMPLEX  217 

ably  evil,  and  that  both  he  and  the  nurse  were 
somehow  contaminated  for  life.  This  very  per- 
ceptible change  in  his  mother's  attitude  toward 
him  caused  him  the  most  acute  and  profound  dis- 
tress. 

These  events,  the  memory  of  which  had  in  large 
measure  faded  from  his  mind,  to  be  recalled  or 
reconstructed  as  here  given  only  in  the  course  of 
the  analysis,  were  mainly  instrumental  in  determ- 
ining the  peculiarities  of  his  adult  love  life.  The 
nurse  was  a  thin  and  very  dark  woman.  Those 
nurses  or  servants  with  whom  the  patient  fell  in 
love  and  experienced  full  sexual  attraction  were 
persons  whom  he  unconsciously  identified  with 
her  on  the  basis  of  similarity  of  appearance  and 
social  level.  These  external  similarities  caused, 
him  xmthinkingly  to  expect  a  total  similarity, 
which  included  a  willingness  to  participate  in 
about  the  same  sort  of  sexual  experiences  he  had 
known  from  his  childhood.^ 

But  while  he  tended  to  identify  nurses  and  serv- 
ants with  the  ''bad"  nurse  of  his  childhood  and  be- 
cause of  their  real  or  fancied  badness  to  feel  com- 
paratively free  sexually  with  them,  the  superior 
type  of  woman,  who  showed  signs  of  refinement 
and  culture,  he  identified  instead  with  his  mother, 
who  had  been  horrified  at  what  took  place  with 
the  nurse  and  whom  he  considered  immaculate  and 
far  above  such  base  interests  as  those  of  sex.    To 

1  He  was  beet  gatisfied  when  in  bis  relations  witli  these  women 
the  earlier  practices  were  reproduced,  perferring  them  to  inter- 
oourse,  though  often  feeling  some  hesitation  in  statii^  thia 
preference. 


218    MORBID  FEAES  AND  COMPULSIONS 

think  of  sexuality  in  connection  with  such  women 
was  to  his  mind  a  sacrilege,  while  in  addition  there 
existed  the  unconscious  expectation  that  they 
would  be  horrified  and  disgusted  by  any  display 
of  erotic  tendencies  on  his  part  as,  in  his  childhood, 
his  mother  had  been.  For  this  reason  he  could 
love  them  only  the  **pure''  way  he  had  loved  his 
mother.  His  sensual  lon^gs  were  inhibited  by 
anything  in  them  reminiscent  of  her  and  he  was 
impotent  in  consequence. 

With  these  examples  we  may  be  prepared  for 
the  mention  of  another  and  most  important  as- 
pect of  the  question  of  transference,  which  we  have 
not  yet  considered,  namely  the  transference  to 
the  physician  which  occurs  in  every  analysis. 
Many  have  seemed  to  think  that  this  transference 
consists  in  little  more  than  the  development  in 
women  of  love  wishes  for  the  doctor.  But  the 
case  is  not  so  simple.  Any  conceivable  sort  of 
impulse  or  feeling  that  the  patient  has  previously 
experienced  may  be  transferred  to  the  analyst, 
irrespective  of  his  age,  sex,  personality  or  any 
other  external  factor.  The  patient  may,  in  other 
words,  unconsciously  identify  the  analyst  with 
any  previously  known  person  of  either  sex,  and 
feel  or  act  toward  him  accordingly.  The  trans- 
ference is  never  love  or  hate  alone,  but  always  a 
mixture  of  both  sorts  of  feeling,  though  one  may 
predominate  and  for  a  time  obscure  the  other. 
For  this  reason  we  distinguish  the  "positive"  (af- 
fectionate) from  the  "negative"  or  hostile  trans- 
ference. 

Because  of  the  nature  of  the  relationship  the 


TEANSFEEENCE  219 

doctor  (if  a  man)  is  most  commonly  identified 
with  the  father  and  consequently  the  feelings 
transferred  are  in  women  predominantly  love 
wishes  and  in  men  hostile  ones,  envy,  jealousy, 
etc  But  this  is  not  invariably  so.  The  doctor 
may  be  identified  with  brother,  mother  or  sister 
(despite  difference  in  sex)  or  with  persons  be- 
longing to  the  patient's  adolescent  or  adult  life. 
He  may  at  one  time  be  identified  with  one  person, 
and  later  with  quite  another. 

The  transference  which  occurs  in  the  analysis 
is  not  created,  but  merely  uncovered,  by  it.  Pa- 
tients carry  on  the  same  transferences  with  other 
physicians  under  different  therapeutic  regimes, 
and  to  just  the  same  degree.  The  transference  to 
the  physician  is  simply  one  phase  of  the  neurotic's 
^'passion  for  transference"  generally,  and  finds 
expression  in  every  contact  of  life.* 

There  is  no  analysis  in  which  transference  does 
not  occur  and  in  which  it  is  not  of  vital  impor- 
tance. Its  proper  handling  is  the  most  difficult 
but  the  most  vital  part  of  psychoanalysis.  In  the 
clinical  chapters  we  shall  deal  with  examples  of 
such  transference. 

iSee  Ferenczi:    Intro jection  and  Transference,  Chapter  II  of 
liis  "ContrilmtionB  to  PsychoanalyBis." 


CHAPTJBB  V 

THB  HEUBOBIB  AS  A  WHOLB 

ANETJBOSIS,  espedallj  when  it  suddenly 
breaks  out  in  a  person  previonslj  in 
seeming  good  health,  has  the  appearance 
of  something  bizarre,  foreign  and  devoid  of  aU 
eontinnity  with  the  rest  of  the  individual's  men- 
tal life.  No  data  within  the  reach  of  his  con- 
sdousness  serve  satisfactorily  to  explidn  its  ad- 
vent or  its 'meaning,  or  to  connect  it  with  the 
main  trends  of  his  ordinary  thought.  The  mal- 
ady appears  not  to  be  of  endopsychic  origin,  but 
more  as  if  the  mind  had  been  invaded  by  a  strange 
something  which,  like  an  infectious  disease  or  a 
demoniac  possession,  would  have  origin  primarily 
from  without. 

The  seeming  discontinuity  between  the  neuro- 
sis and  the  rest  of  the  individual's  personality 
and  psychic  life  is  not  real  but  only  apparent.  It 
is  conditioned  by  the  fact  that  the  malady  has 
origin  in  trends  which  are  unknown  to  the  patient, 
rather  than  in  those  whose  existence  he  realizes. 
As  soon  as  these  unconscious  processes  are  known 
it  is  easy  to  see  that  there  is  a  continuity  between 
the  neurotic  symptoms  and  all  other  elements  of 
the  patient's  mental  life — a  continuity  which  is 
everywhere  complete.  The  neurosis  is  neither  an 
invasion  of  the  personality  by  something  f  oreigUi 

220 


FAILUEE  OF  EEPEESSION         221 

nor  a  neoplastic  excrescence  which  develops  on  its 
snrf  ace,  leaving  the  underlying  strata  unchanged, 
but  rather  a  composite  expression  of  its  totality, 
an  extract  which  contains  something  of  all  its 
vital  constituents. 
^  The  necessary  condition  for  the  processes  of 

the  Unconscious  to  manifest  themselves  in  this 
abnormal  way  (as  neurotic  symptoms)  is  a  fail- 
ure of  repression.  The  efferent  avenues  to  dis- 
charge as  affeotivity  or  action  are  normally  xm- 
der  the  control  of  the  f  oreconsdous  and  conscious 
systems.  Only  those  trends  come  to  expression 
which  are  in  accord  with  their  specifications  and 
are  passed  by  their  censorship.  When  a  neurosis 
comes  into  existence  it  means  that  the  sway  of 
these  normally  ruling  forces  has  in  some  degree 
been  broken  tiirough.  The  trends  of  the  Uncon- 
scious which  in  this  way  come  to  the  surface  as 
symptoms  are  not  necessarily  greatly  different 
from  what  a  normal  person  would  possess.  The 
essential  pathologic  feature  is  the  failure  of  the 
repression.  Thus  an  outlet  is  gained  by  forces 
which  in  the  normal  would  either  be  repressed 
completely  or  their  energy  diverted  to  paths  of 
discharge  which  presented  no  conflict  with  the 
ruling  trends  residing  in  the  f  oreconscious.  The 
content  of  the  Unconscious  in  both  normal  and 
neurotic  is  qualitatively  about  the  same. 

The  failure  of  repression  which  allows  the  Un- 
conscious to  manifest  itself  in  what  we  know  as 
symptoms  is,  however,  in  the  neurosis,  never  com- 
plete. The  repressing  forces  are  not  overthrown 
en  masse  (as  in  certaia  forms  of  psychosis)  nor  do 


222    MORBID  PEAES  AND  COMPULSIONS 

those  of  the  TJnconscions  gain  full  license  to  ex- 
press themselves.  The  failure  of  repression  is 
only  a  partial  one.  To  some  degree  the  repress- 
ing forces  give  in  to  the  repressed,  and  the  re- 
pressed to  the  repressing.  The  result,  the  neuro- 
sis and  its  symptoms,  is  thus  a  sort  of  comprom- 
ise brought  about  by  mutual  concessions  on  the 
part  of  forces  which  actually  are  at  war. 

While  the  repressing  trends  sacrifice  something 
in  allowing  to  the  repressed  any  manifestation 
at  all,  they  in  their  turn  make  a  reciprocal  sacri- 
fice in  the  form  of  limitations  as  to  the  modes  in 
which  they  are  to  be  expressed.  Though  allowed 
some  expression  they  are  restricted  to  such  varie- 
ties as  appear  to  conform  with  the  censorship 
and  show  no  open  disharmony  with  the  individ- 
ual's  ethico-esthetic  feelings  and  his  ego-ideal. 
Trends  really  incompatible  with  the  superior 
strata  of  the  personality  and  which  a  perfect  re- 
pression would  exclude,  now  secure  representation 
in  consciousness  under  the  condition  that  they  be 
so  disguised  and  distorted  that  their  true  mean- 
ing is  not  revealed.  The  neurotic  symptoms,  like 
the  dream,  are  then  manifestations  of  the  Uncon- 
scious, accomplished  by  means  indirect,  menda- 
cious, and  equivocal.  The  qualities  of  the  symp- 
toms are  neither  wholly  those  of  the  Unconscious, 
nor  wholly  those  of  the  higher  systems,  but  in 
varying  degree  partake  of  the  nature  of  both. 

As  we  know,  the  Unconscious  can  only  wish. 
It  has  no  other  energy  than  conative  tensions ;  its 
active  content  is  aU  desire.  The  forces  which 
break  through  the  repression  and  supply  the  mo- 


SEXUAL  FACTOR  223 

tive  power  for  the  neurotic  symptoms  are  wishes 
of  the  Unconscious.  The  symptoms  (again  like 
the  dream),  are  an  attempted  realization  of  one  or 
more  unconscious  wishes.  But  we  can  say  some- 
thing about  the  nature  of  these  wishes.  '^  Ac- 
cording to  a  rule  which  I  had  always  found  sub- 
stantiated," writes  Freud,  'Hhe  symptom  signifies 
the  representation  (realization)  of  a  phantasy 
with  a  sexual  content,  and  so  a  sexual  situation.  I 
might  better  say,  at  least  one  of  the  meanings  of 
a  symptom  corresponds  to  the  realization  of  a 
sexual  phantasy,  while  for  the  other  meanings 
there  is  no  such  limitation  of  content.''^  The 
wishes  which  the  symptoms  attempt  to  realize,  in 
other  words,  belong  in  the  main  to  the  holophilic 
instinct. 

Statements  of  this  sort  have  excited  a  great  deal 
of  opposition.  Why,  many  have  asked,  must  the 
central  factor  of  the  neurosis  be  a  sexual  one? 
Why  cannot  conflicts  between  non-sexual  wishes 
produce  symptoms?  Why  may  not  cases  occur 
in  which  the  sex  factor  plays  no  important  part? 

I  do  not  know  that  these  questions  really  have 
to  be  answered.  The  essential  matter  at  present 
is  not  so  much  why  the  sexual  factor  is  the  central 
one  in  the  neurosis  but  that  it  is.  Freud's  state- 
ments are  based  on  empirical  observation,  not  on 
theoretical  speculation.  I  am  well  aware  that  cer- 
tain individuals  have  published  reports  of  cases 
in  which,  they  assert,  the  sexual  factor  was  ab- 
sent, and  that  all  the  symptoms  were  to  be  ex- 

1  "Bruchgtlick   einer   Hyvterienanalyae/'   Samml.   kl.   Schr.   c. 
Neuroienl.  II. 


224    MORBID  FEARS  AND  COMPULSIONS 

plained  on  other  grounds.  Bat  there  are  no  real 
\  exceptions  to  Freud's  rule.  I  do  not  hesitate  to 
assert  that  the  sexual  factor  was  present  in  these 
>  cases  but  that  the  observer  failed  to  see  it.  This 
is  evident  ordinarily  from  the  reports  themselves. 
For  on  the  one  hand  they  show  the  sexual  ele- 
ment present  in  some  veiled  f  orm,  and  on  the  other 
that  the  observer  was  totally  ignorant  of  the 
means  (and  often  of  the  need)  of  overcoming  the 
patient's  resistances  in  order  to  allow  this  factor 
to  come  to  clear  expression. 

No  one  would  be  so  absurd  as  to  assert  that  per^ 
sons  exist  who  have  no  sexual  instinct  at  all. 
The  most  frigid  woman  has  a  sexual  instinct,  even 
granting  (what  is  most  unlikely)  that  she  has  not 
and  never  did  have  any  conscious  sexual  feelings. 
And  if  she  has  a  sexual  instinct,  it  must  play  some 
part  in  her  mental  life,  even  supposing  (another 
impossible  state  of  affairs)  that  it  is  wholly  con- 
fined to  the  Unconscious.  In  the  face  of  the  num- 
berless observations  which  found  the  sexual  fac- 
tor present  and  dominant  in  the  neurosis,  the 
only  sort  of  case  report  that  should  have  any 
weight  against  Freud's  statement  would  be  one 
which  not  only  connected^ the  symptoms  with  ex- 
clusively non-sexual  factors,  but  at  the  same  time 
traced  the  sexual  instinct  through  all  its  ramifica- 
tions and  shqwed  what  it  was  doing  and  how  it  did 
manifest  itself.  Nobody  has  ever  done  this  or 
apparently  ^ver  attempted  it.  Those  who  assert 
that  the  symptoms  in  their  cases  were  of  non- 
sexual origin  tell  us  nothing  of  how  the  sex  im- 
pulses were  disposed  of  in  these  patients.    With 


SEXUAL  FACTOR  225 

a  force  so  subtle,  so  pervasive  and  so  wide  in  its 
radiations  as  the  sex  instinct  no  one  should  trust 
himself  to  say  where  it  isn%  unless  he  knows  in 
fullest  detail  where  it  is. 

My  own  experience  is  that  the  sexual  factor 
comes  to  expression  in  every  analysis  almost  at 
once — ^usually  within  the  first  two  or  three  visits. 
And  I  am  sure  that  for  this  result  no  special  tech- 
nique or  dexfterities  are  required ;  about  all  that  is 
necessary  being  to  let  the  patient  talk.  On  the 
other  hand  there  is  something  required  of  the 
analyst.  Neurotic  patients  are  quick  to  sense 
what  sort  of  impression  they  are  making.  And 
if  the  doctor  is  himself  tied  up  with  sexual  re- 
sistances and  repressions,  so  that  he  cannot  look 
upon  the  content  of  the  patient^s  '^ confession" 
without  prejudice  and  without  emotion,  and  sim- 
ply as  a  matter  of  biological  fact,  the  patient,  in 
many  instances,  will  divine  this  beforehand  and 
the  confession  will  consequently  never  be  made. 
Nobody  can  thoroughly  investigate  the  permea- 
tions of  the  sex  impulses  in  another  person  with- 
out having  first  traced  them  in  himself.  And  this 
he  cannot  do  alone.  It  requires  the  help  of  an- 
other person  to  overcome  the  resistances  (which 
all  of  us  have)  and  until  these  are  overcome  and 
one  is  permitted  to  see  himself  de&rly,  he  will  be 
blind  to  whatever  in  his  patients  he  also  possesses 
but  would  not  wish  to  see  in  himself.  A  person 
can  not  see  through  the  disguises  of  sexuality  in 
his  patients  when  in  himself  the  same  or  sindlar 
disguises  exist  unpenetrated. 

When  I  say  that  the  doctor's  own  blindness 


\ 


226    MORBID  FEARS  AND  COMPULSIONS 

rather  than  any  real  absence  of  the  sexnal  factor 
was  responsible  for  the  oases  reported  as  excep- 
tions to  Freud's  rnlCi  I  intended  no  reproach  to 
these  men,  for  I  believe  that  they  are  thoronghly 
sincere.  The  reproach,  if  there  is  any,  belongs 
not  to  them  bat  to  our  unnatural  and  hypocritical 
cultural  and  conventional  standards,  in  the  face 
of  which,  for  those  who  accept  them,  self-deceit  is 
well  nigh  unavoidable  and  only  ignorance  is  bliss. 
As  long  as  we  are  taught  and  believe  that  there 
is  something  disgraceful  about  having  a  sex  in- 
stinct, we  have  either  to  give  up  being  honest  with 
ourselves  or  else  to  give  up  our  self-respect. 

To  the  question  with  which  we  began  the  discus- 
sion. Why  is  the  sexual  factor  dominant  in  every 
neurosis  T  I  shall  not  attempt  to  make  any  de- 
tailed reply.  The  answer  is  perhaps  to  be  sought 
in  the  direction  indicated  by  Meyer  when  he  says : 
''No  experience  or  part  of  our  life  is  as  much 
disfigured  by  convention  as  the  sex  feelings  and 
ambitions."  ^  That  is  to  say,  if  we  had  other  im- 
pulses which  throughout  the  whole  life  of  the  indi- 
vidual were  so  consistently  and  unremittingly 
warped,  cramped  and  deformed  in  every  conceiv- 
able and  unnatural  manner,  and  they  had  the  same 
strength  to  rebel  against  such  treatment  as  have 
the  sex  impulses,  then  we  might  have  neuroses  in 
which  they  and  not  the  sex  factor  played  the 
dominant  role. 

The  statement  that  the  wishes  which  the  neu- 

1  Adolf  Meyer:  A  Ditouuion  of  Same  Fundamental  leeuee  ii» 
Freud^B  Peychoanalpeie,  State  Hoepitdle  BuUetinf  Vol.  II,  Ko. 
4,  1910. 


SEXUAL  FACTOR  227 

rotic  symptoms  attempt  to  realize  are  predomi- 
nantly sexual  requires  some  qualification.  The 
word  sexual  must  not  here  be  interpreted  in  its 
popular  sense.  T}ie  wishes  in  question  belong 
more  to  the  infantile  than  to  the  adult  sexuality. 
The  basic  ones  are  continuations  and  descendants 
of  holophilic  impulses  normally  present  in  infancy 
or  childhood  but  which  in  a  perfectly  evolved  sex 
life  become  subordinate  to  the  genital  primacy, 
give  up  their  energy  to  sublimation  formations  or 
subside  into  a  state  of  latency  and  perfect  repres- 
sion. But  in  the  neurotic  they  either  retain 
measures  of  energy  that  should  have  been  em- 
ployed elsewhere,  or  else,  having  been  temporarily 
deprived  of  such  activation,  they  regain  it  through 
a  damming  up  of  libido  consequent  upon  failures 
to  secure  satisfaction  through  the  external  world. 
It  ii9  from  that  portion  of  the  individual's  sexu- 
ality which  has  failed  to  complete  the  normal 
ontogenetic  evolution,  rather  than  from  the  nor- 
mally synthetized  and  adult  portion,  that  the  mo- 
tive force  of  the  neurotic  symptoms  is  mainly 
derived.^ 

1  Some  yean  ago  a  promineiii  neurologist  said  to  me:  '^Freud's 
theory  that  the  neuroies  depend  upon  uneatiified  aeznal  wlahes 
is  absurd  on  the  face  of  it.  Why  at  least  fifty  percent,  of 
neurotic  women  haven't  any  desire  for  Intercourse  at  all.'* 

I  quote  this  as  a  fair  example  of  some  of  the  criticisms  of 
Freud's  Tiews.  It  shows  quite  typically  how  ignorant  many  of 
his  critics  are  on  the  one  hand  of  the  facts  of  the  sex  life*  and 
on  the  other  of  the  theories  they  are  criticising. 

It  is  not  Freud's  theory  that  a  oofMoioiie  desire  for  Merooiirte 
Is  responsible  for  the  neurosis.  In  fact  the  presence  of  a  weU 
dereloped  desire  of  that  character  instead  of  indicating  that  a 
woman  was  likely  to  derelop  a  neurosis  would  more  reasonably 


228    MOBBID  FEABS  AND  COMPULSIONS 

Bat  to  say  that  the  wishes  which  are  expressed 
in  the  neurosis  have  the  character  of  infantile  sex- 
uality rather  than  that  of  adult  life  is  the  same 
thing  as  saying  they  or  their  sources  are  essen- 
tially perverse.  For  we  have  learned  that  the 
characteristic  feature  of  the  infantile  sexuality 
is  that  it  is  ** polymorphous-perverse/'  Both 
neurosis  and  perversion  represent  a  disposition  of 
a  portion  of  the  libido  to  channels  at  one  time 
normal  but  from  which,  for  an  adult  love-life,  its 
main  currents  should  be  withdrawn  and  employed 
elsewhere.  Those  tendencies  which,  in  the  per- 
version, are  continued  on  the  surface  and  con- 
sciously, are  in  the  neurosis  maintained  in  the 
Unconscious  in  subjection  to  varying  degrees  of 
repression.  The  neurosis,  its  Freud  expresses  it, 
is  the  negative  of  the  perversion.^  Both  represent 
a  partial  arrest  of  development.  Meanwhile  it 
may  be  added  that  though  every  neurosis  is  an 
attempted  realization  of  infantile,  sexual  and  per- 
verse wishes,  not  every  wish  that  the  neurosis 
attempts  to  realize  is  either  infantile,  sexual  or 

Bignify  that  she  would  not.  It  ia  the  vmcotuoious  and  reprened 
/■exual  wishes  of  the  patient  which  furnish  the  neurosis  with  its 
motive  power.  The  desire  for  intercourse  is  only  a  «maZI  pari  of 
•ewwUity,  not  the  whole  of  it»  as  this  speaker  seemed  to  think 
and  it  is  often  the  least  among  those  sexual  wishes  which  go 
to  form  the  neurotic  symptom.  "Frigid"  women  are  no  more 
lacking  in  sexuality  than  are  "passionate^'  ones  but  are  more 
likely  to  develop  a  neurosis.  As  a  matter  of  fact,  many  of  the 
women  who  are  anaesthetic  during  intercourse  are  continually 
indulging  in  erotic  day  dreams,  and  in  many  cases  are  chronio 
masturbators. 

1  Freud:  "Selected  Papers  on  Hysteria  and  Other  Pftyohoneift- 
roses,"  Chapter  IX. 


NEGATIVE  OF  PERVERSION       229 

perverse.  The  neurotic  symptom  is  almost  in- 
variably a  condensation  product,  expressing 
several  wishes,  and  is  thus  ^^overdetermined." 
Non*sexual,  non-infantile  and  non-perverse 
wishes  may  furnish  determinants,  but  they  alone 
do  not  caitse  the  neurosis. 

What  has  been  said  about  the  libido  remaining 
in  channels  of  distribution  corresponding  to  de- 
velopmental phases  that  should  have  been  left  be- 
hind brings  us  to  the  important  matter  which  is 
tedmically  known  as  ^^ fixation.''  James  points 
out  a  phenomenon  which  he  calls  ^Hhe  inhibition 
of  instincts  by  habif  **When  objects  of  a  cer- 
tain class  elicit  from  an  animal  a  certain  sort  of 
reaction,"  he  writes,  '4t  often  happens  that  the 
animal  becomes  partial  to  the  first  specimen  of 
the  class  on  which  it  has  reacted  and  will  not 
afterwards  react  on  any  other  specimen. 

''The  selection  of  a  particular  hole  to  live  in, 
of  a  particular  mate,  of  a  particular  feeding 
ground,  a  particular  variety  of  diet,  a  particular 
anything,  in  short,  out  of  a  possible  multitude,  is  a 
very  widespread  tendency  among  animals,  even 
those  low  down  in  the  scale.  The  limpet  will  re- 
turn to  the  same  sticking-place  in  its  rock,  and  the 
lobster  to  its  favorite  nook  on  the  seQ.-bottom. 
The  rabbit  will  deposit  its  dung  in  the  same  cor- 
ner; the  bird  makes  its  nest  on  the  same  bough. 
But  each  of  these  preferences  carries  with  it  an 
insensibility  to  other  opportunities  and  occasions 
— an  insensibility  which  can  only  be  described 
physiologically  as  an  inhibition  of  the  new  im- 
pulses by  the  habit  of  the  old  ones  already  formed. 


230    MOEBID  FEARS  AND  COMPULSIONS 

.  •  •  A  habit,  once  grafted  on  an  instinctive  tend- 
ency, restricts  the  range  of  the  tendency  itself, 
and  keeps  ns  from  reacting  on  any  but  the  hab- 
itual object,  although  other  objects  might  just  as 
well  have  been  chosen  had  they  been  the  first- 
comers/*^ 

This  establishing  through  use  or  habit  of  a 
partiality  for  particular  specimens  of  general 
classes  is  apparently  the  same  thing  as  that  which, 
when  occurring  in  the  human  sexual  sphere, 
Freud  calls  fixation.  For  the  holophilic  impulses, 
when  repeatedly  gratified  either  singly  or  in  con- 
junction by  a  given  person  (or  object),  tend  to 
become  partial  to  that  particular  person  and  cor- 
respondingly insensitive  to  others  of  the  same 
dass.  These  impulses  or  their  libido  are  then 
said  to  be  ** fixed**  on  that  person  or  the  corre- 
sponding ^  ^  imago.  *  *  Normal  love  constancy  is  an 
example  of  an  ** inhibition  by  habit**  or  ** fixation*' 
which  involves  the  main  current  of  the  libido  and 
practically  the  whole  group  of  the  synthetized 
holophilic  impulses. 

But  what  James  has  said  concerning  the  tend- 
encies of  an  impulse  to  become  fixed  upon  the 
object  which  has  gratified  it  also  applies  (at  least 
in  the  case  of  the  human  holophilic  impulses)  to 
the  aim  as  well,  that  is,  to  the  type  of  action  which 
gratifies  the  impulse  and  gives  the  libido  dis- 
charge. A  peculiarity  of  the  holophilic  impulses 
is  that  they  are  not  in  the  beginning  specific  with 
regard  to  aim.  Each  one  may  secure  gratifica- 
tion in  mcmy  ways,  or  through  any  one  of  a  num- 

1  William  James:  "PrindpleB  of  Psychology/'  Vol.  II,  pa^  394. 


FIXATION  231 

ber  of  really  quite  different  actions,  in  distinction 
to  the  hunger  impulse  which  can  be  satisfied  in  no 
other  way  than  by  eating.  Were  it  not  for  this 
non-specificity  of  the  holophilic  tendencies,  such  a 
thing  as  sublimation,  where  the  libido  belonging 
to  a  holophilic  impulse  finds  satisfaction  in  actions 
that  are  not  sexual  at  all,  would  be  quite  impos- 
sible. But,  through  repeated  activity,  part  or  all 
of  the  libido  of  an  impulse  may  become  inhibited 
by  habit  or  fixed  on  the  sort  of  action  that  pro- 
duced the  gratification,  whereupon  the  claims  of 
the  impulse  to  that  extent  become  specific;  its 
libido  is  deprived  of  the  original  mobility,  a  pref- 
erence is  established  for  this  particular  sort  of 
action,  with  a  corresponding  indifference  to  others 
which  might  also  have  represented  possibilities  of 
satisfaction.  In  fact  the  tendency  of  the  libido  to 
form  fixations  applies  not  only  to  aim  and  object 
but  in  some  degree  to  the  whole  ensemble  of 
repeated  gratifying  experiences,  even  including 
incidental  and  essentially  indifferent  features  of 
external  circumstance  associated  with  the  gratifi- 
cation.^ The  essential  point  in  all  this  is  that  the 
greater  the  portion  of  the  individual's  libido 
which  has  undergone  fixation,  the  more  circum- 
scribed is  the  range  of  its  possibilities  for  appli- 
cation and  the  more  the  individual  is  limited  to 
loving  certain  particular  objects  and  in  certain 
particular  and  definite  ways. 

I  said  in  the  first  chapter  that  though  auto- 
erotism preponderates  in  the  picture  of  the  inf  an- 

1  Compare  what  has  alreadj  been  said  concerning  the  condi- 
tioned refleZf  in  the  section  on  Transference,  psge  197. 


232    MOBBID  FEARS  AND  COMPULSIONS 

tile  holophilic  activities,  nevertheless  there  is 
some  objeot-love  even  in  these  early  years,  namely 
that  which  the  child  feels  for  the  members  of  the 
family.  A  second  object-selection  occurs  after 
puberty  when  the  sexual  synthesis  has  been  com- 
pleted and  object-love  is  the  main  feature  of  the 
sexual  life.  It  has  also  been  indicated  (in  the 
section  on  Transference)  that  the  first  or  infan- 
tile object-selection  has  a  lasting  influence,  more 
profound  in  some  persons  than  in  others,  through- 
out the  individual's  life.  In  other  words,  a  vary- 
ing portion  of  the  individual's  libido  is  fixed  upon 
the  unconscious  imagines  of  the  loved  persons  of 
early  years  and  strives  continually  to  repeat  the 
early  love  experiences,  either  in  phantasy  (con- 
scious or  unconscious)  or  in  the  form  of  transfer- 
ences to  new  persons  who  can  be  identified  with 
and  form  acceptable  substitutes  for  the  old.^  This 
unconscious  portion  of  the  libido  has  a  directing 

1  We  must  not  be  oonf  used  by  such  eases  as  the  one  mentioned 
in  the  section  on  transference  of  the  man  who  reacted  to  many 
persons,  including  street  car  conductors  and  a  waiter,  as  if  they 
were  his  father.  At  first  glance  such  a  case  might  not  seem  to 
be  the  inhibition  by  habit  through  which  the  individual  '*wiU 
not  afterward  react  on  any  other  specimen  of  a  certain  class.'* 
It  seems  rather  the  reverse  of  such  inhibition  and  as  if  habits 
instead  of  limiting  the  numbers  of  a  class  to  which  the  individual 
would  reacts  had  abnormally  increased  them.  The  case  is  only 
an  apparent  contradiction  to  the  rule.  Psychologically  the  pa- 
tient was  not  reacting  to  d^er&ni  members  of  a  class,  now  a 
conductor,  now  a  waiter,  etc.,  but  rather  to  the  same  person  all 
the  time,  namely  the  father.  The  fidelity  of  the  fixation  was  so 
great  that  it  required  only,  as  it  were,  a  part  of  the  father  (loud 
voice,  stem  manner,  etc.)  to  touch  off  the  reaction.  The  possi- 
bilities of  reacting  to  a  waiter,  an  hotel  olerh  or  a  oonductor 
were  ignored. 


FIXATION  233 

influence  in  fhe  second  object-selection.  For  in- 
stance,  the  man  is  most  drawn  to  those  women  who 
give  promise  of  satisfying  these  unconscious 
strivings — ^those  who  present  such  qualities  that 
give  rise  to  an  unconscious  identification  with  the 
imago  of  mother,  sister  or  some  other  loved 
woman  of  the  years  of  childhood.  This  influence 
is  perhaps  most  apparent  in  the  first  love  affairs 
of  a  young  man  which  quite  frequently  are  with 
a  woman  considerably  older  than  himself,  in  many 
cases  a  married  woman,  while  he  tends  to  show 
toward  her  more  or  less  of  the  same  respectful 
adoration  he  felt  for  his  own  mother.^ 

But  though  the  influence  of  the  first  object- 
selection  always  makes  itself  felt  in  the  second,  it 
cannot  be  said  to  dominate  the  picture  in  the  case 
of  normal  people.  The  normal  person  reaches 
adult  life  with  a  wide  range  for  object  choice. 
Thus  a  healthy  man  can  fall  in  love  almost  equally 
readily  with  any  one  of  a  large  number  of  women, 
and  when,  through  the  accident  of  propinquity  or 
some  similar  factor,  he  has  done  so  with  one  of 

1  Does  the  woodpecker  flit  round  the  young  feraahf 
Does  the  grass  clothe  a  new-built  wallT 
Is  she  under  thirty  the  woman  who  holds  a  boy  in  her  thrall  t 
RuDTABD  Kipling:  "Certain  McuHma  of  Eafits.** 

I  was  a  young  un  at  Oogli, 

Shy  as  a  girl  to  begin; 
Aggie  de  Castrer  she  made  me. 

And  Aggie  was  clever  as  sin; 
Older  than  me,  but  my  first  un-' 

More  like  a  mother  she  were— 

TheLadiea. 

Many  of  this  writer's  stories  give  good  pictures  of  object-selec- 
tion dominated  by  the  mother  complex. 


234    MOBBID  FEABS  AND  COMPULSIONS 

them,  he  is  satisfied  with  her,  and  relatively  indif- 
ferent to  others  for  an  indefinite  period.  In  other 
words,  his  sexnal  ideal  is  qnite  indasive  and  his 
love  specifications  are  not  very  strict 

But  with  the  neurotic  it  is  otherwise.  His  love 
specifications  are  much  more  strict  and  numerous, 
his  sexual  ideal  is  exclusive,  his  requirements  for 
loving  are  difScult  to  fulfill.  Instead  of  his  being 
able  to  content  himself  with  any  one  of  a  large 
number  of  women,  there  are  but  few  whom  he 
could  fall  in  love  with  and  find  satisfying  for  long. 
This  results  from  the  fact  that  a  larger  portion  of 
his  libido  is  fixed  upon  the  images  and  the  aims 
corresponding  to  the  first  object  choice.  His 
tastes  in  love  matters  are  already  formed  when 
he  is  still  a  child,  and,  up  to  a  certain  point,  their 
demands  are  peremptory  and  inexorable. 

Fixation  means,  ordinarily,  that  the  greater 
portion  of  that  libido  which  is  distributed  to  the 
infantile  channels  and  strives  to  repeat  the  early 
love  experiences,  can  only  to  a  limited  degree 
be  gratified  by  reality.  For  on  the  one  hand, 
there  are  lacking  in  reality  the  objects  that  would 
gratify  these  earlier  formed  wishes,  or  external 
obstacles  would  stand  in  the  way  of  such  gratifi- 
cation, even  if  the  objects  were  available ;  and,  on 
the  other,  the  situations  necessary  to  gratify  these 
wishes  cannot  be  realized  because  of  internal 
inhibitions.  That  is  to  say,  the  unconsciously 
desired  object  is  an  incestuous  one,  or  the  desired 
aim  perverse ;  hence  the  constellation  meets  with 
resistances  on  the  part  of  the  f oreconscious  which 
not  only  prohibit  real  gratification  of  the  wishes. 


FIXATION  235 

should  real  gratification  be  possible,  but  also  pre- 
vents the  individual  from  becoming  aware  of  their 
existence.  The  wishes  in  question  have,  in  other 
words,  to  remain  unconscious  and  repressed  in- 
stead of  being  directed  to  real  and  external 
things ;  and  in  the  main  no  gratification  is  possible 
save  when  a  breaking  through  the  censorship  al- 
lows their  representation  in  consdousness  in  such 
forms  as  neurotic  symptoms  and  dreams.^ 

1  It  has  seemed  to  me  that  somewhere  in  this  problem  of  fixa- 
tion is  to  be  sought  the  answer  to  that  very  baffling  question. 
In  what  respect  is  the  constitutional  neurotic  different  from  the 
normal  person^  fundamentalljt  Jung  has  said:  "In  a  oertaiB 
senaitiveness/'  which  to  my  mind  is  about  the  same  as  saying: 
"In  possessing  a  greater  tendency  to  form  fixations.*'  Neither 
statement^  it  must  be  confessed,  means  very  much.  I  am,  how- 
ever, of  the  opinion  that  'the  greater  tendency  to  form  fixations" 
is  not  something  primary  or  inherent  but  secondary  to  a  sexual 
precocity.  The  neurotic  is  a  person  who  has  learned  to  love,  and 
jh^.fi  too  soon.  His  holophilic  feelings  possess  almost  adult 
intensity  while,  in  years  and  in  his  modes  of  reaction,  he  is  stiU 
a  child.  The  greater  tendency  to  form  fixations  is,  then,  it  seems 
to  me,  simply  a  result  of  this  holophilic  prematurity.  It  is  as  if 
the  holophilic  impulses  tend  to  become  fixed  when  they  attain  a 
certain  level  of  intensity  or  possess  a  certain  measure  of  libido. 
Thus  if  this  intensity  is  reached  prematurely,  a  premature  fixa- 
tion occurs.  This  is  in  accord  with  the  observations  that  exter- 
nal factors  such  as  repeated  seductions  or  too  much  love  and 
petting  from  the  parents,  both  of  which  tend  to  develop  intense 
love  emotions  in  the  child,  have  almost  the  same  tendency  to  pre- 
dispose to  a  neurosis  as  the  constitutional  factors. 

I  should  perhaps  emphasize  that  I  mean  not  a  qualitattve  but 
a  quantitative  precocity.  So  far  as  I  know  there  is  no  essential 
difference  in  kind  between  the  infantile  holophilic  impulses  and 
Interests  of  a  normal  child  and  those  of  one  who  will  later  become 
a  neurotic  The  basic  difference  is,  it  seems  to  me,  that  those 
of  the  latter  are  more  fiileiMe»  and  represent  a  greater  measure  of 
libido.  On  the  other  hand,  it  is  just  as  possible  that  it  is  not 
so  much  the  intensity  as  the  frequency  of  the  reactions  which  is 


236    MOBBD)  FEABS  AND  COMPULSIONS 

The  practical  dement  in  the  question  of  fixation 
18  that  the  points  at  which  fixation  oocnrs 
(whether  they  be  fixation  in  respect  to  ob- 
ject or  in  respect  to  aim)  are  loci  minaris 
resistentuB  in  the  synthesis  of  the  holophilio 
impnlses.  Whatever  portion  of  the  libido  is  sub- 
ject to  fixation  diminishes  the  amount  which  is 
left  free  for  distribution  to  aims  and  objects 
of  the  external  world.  And  when  that  portion 
which  has  been  directed  and  satisfied  externally 
is,  through  meeting  with  some  obstacle,  loss 
or  disappointment,  cut  off  from  that  which  had 
satisfied  it,  a  damming  up  of  the  libido  all  too 
readily  occurs  and  the  tension  has  a  tendency  to 
expend  itself  in  those  directions  which  formerly 
afforded  an  outlet.  In  other  words,  the  libido  is 
apt  to  regress  to  earlier  lines  of  discharge  and 
thus  augments  that  portion  already  fixed  and  im- 
perfectly satisfied.  The  unconscious  strivings  for 
repetition  of  the  infantile  gratification  experi- 
ences thus  receive  a  powerful  reenforcement, 
which  me]^aces  the  previously  serviceable  repres- 
sion and  may  be  strong  enough  to  break  through  it 
and  form  a  neurosis.  This  regression  doubtless 
follows  the  same  familiar  principle  that  the 
tensions  corresponding  to  states  of  temporary 
excitement  may  overflow  through  earlier  chan- 
nels of  discharge,  and  produce  reactions  which  are 
entirely  unoriented  with  and  unadapted  to  the 

the  deciding  factor  for  fixation.  The  same  reaction  patterns 
which  exist  in  the  normal  chUd  may  be  worn  more  deeply  in  the 
neurotic  through  being  more  often  traversed.  AU  thi^  •gaiHt 
does  not  metn  very  much. 


EEaEESSION  237 

realities  of  the  immediate  situation.  For  in- 
stance, a  German  living  in  this  country  who  has 
habitually  spoken  and  thought  in  English  for 
years  nevertheless  will,  if  very  angry  or  otherwise 
excited,  relapse  into  his  mother  tongue,  despite 
the  fact  that  perhaps  none  of  his  hearers  can  un- 
derstand a  word  he  says.  Examples  such  as  this 
are  within  the  sphere  of  every  one's  experience. 

When  I  was  an  interne  in  Bellevue  I  was  struck 
.  by  the  fact  which  at  that  time  I  could  not  inter- 
pret, that  oftentimes  a  man  in  sudden  and  intense 
pain  (such  for  instance  as  might  be  caused  by 
manipulating  a  fracture)  would  call  for  his 
mother.  To  hear  wails  of  '^  Mama  I  Mama! 
Help  me !''  from  some  of  those  hardened  old  repro- 
bates of  the  alcoholic  or  prison  wards  whose  grim, 
craglike  faces  gave  as  little  suggestion  of  the 
lurking  presence  of  soft  memories  of  mother  love 
as  would  the  rock  of  Gibraltar,  was  indeed  a 
thought-provoking  experience,  particularly  if  one 
happened  to  know  that  the  mother  in  question  had 
been  m  her  grave  for  years,  assisted  thereto  by 
unfeeling  abuse  received  at  the  hands  of  the 
waller.  The  essential  futility  of  the  reaction 
(calling  for  help  to  a  person  neither  present  nor 
living),  its  implicit  lack  of  orientation  as  to  time 
and  reality,  its  infantilism  and  its  utter  discon- 
gruity  witii  all  that  ordinarily  held  sway  in  the 
individual's  character,  might  well  have  prepared 
me  for  the  regressions  I  was  later  to  see  expressed 
in  neurotic  symptoms,  whose  only  essential  differ- 
ence is  that  they  are  not  so  short  lived. 

But  the  regressions  of  the  dammed  up  libido  to 


238    MORBID  FEARS  AND  COMPULSIONS 

the  old  paths  left  by  earlier  real  or  attempted  dis- 
charge is  not  merely  one  from  the  present  back  to 
the  pasty  but  from  the  real  and  the  external  inward 
to  the  imaginary.  The  libido,  or  a  portion  of  it, 
is  withdrawn  from  reality,  the  individual  losing 
some  of  his  interest  in  the  world  and  persons 
about  him,  and  this  energy  is  then  applied  to 
phantasy,  and  seeks  gratification  according  to  the 
old  pain  and  pleasure  principle  which  attempts  to 
satisfy  all  wishes  by  the  hallucinatory  route. 
This  process  has  been  generally  known  as  Intro- 
version, according  to  the  convenient  term  which 
Jung  introduced.  Introversion  is  an  essential 
preliminary  to  the  production  of  any  neurosis. 

The  great  increase  in  the  amount  of  libido  which 
normally  attends  the  attainment  of  puberty 
usually  results  in  a  period  of  masturbation  in 
which  phantasy  supplies  the  sexual  object,  chosen 
after  the  model  of  the  infantile  imagines,  but 
which  reality  still  withholds.  Later  the  libido 
gradually  becomes  transferred  from  these  phan- 
tasies and  goes  over  into  action  which  shall  event- 
ually win  real  satisfaction  from  real  objects  in 
the  external  world.  Now,  introversion  reverses 
this  process.  The  libido  is  withdrawn  from  those 
actions  which  might  serve  to  win  a  sexual  object 
and  real  satisfaction  in  the  external  world.  In- 
stead of  to  the  real  sexual  objects  and  gratifica- 
tions thus  despaired  of,  it  is  directed  to  phan- 
tdsies  of  gratification;  first  perhaps  to  conscious 
ones,  but  shortly  it  regresses  stUl  further  to  phan- 
tasies which  are  unconscious.  The  phantasies 
thus  re-activated  are  either  those  which  were  once 


INTEOVEETED  LIBIDO  239 

conseions,  in  the  form  of  some  of  the  masturbatic 
phantasies  of  puberty,  which  were  later  forgotten, 
or  those  which  had  been  formed  in  the  Uncon- 
scions  and  were  never  known  to  the  individual. 
In  them  the  external  sexual  object  of  adult  life  is 
usually  succeeded  by  an  incestuous  one  corre- 
sponding to  the  infantile  imagines,  while  perverse 
aims  take  the  place  of  those  of  normal  sexuality.^ 
This  return  of  the  libido  from  reality  to  refill 
the  channels  left  by  the  infantile  holophilic  reac- 
tions and  revivify  the  old  unconscious  phantasies 
corresponding  to  the  incestuous  images  and  per- 
verse aims  is  an  invariable  and  necessary  prelim- 
inary to  the  production  of  any  neurosis.  The 
neurosis  has  origin  from  the  introverted  portion 
of  the  libido  which,  partially  overcoming  the  re- 
pression, seeks  to  realize  unconscious  phantasies 
corresponding  to  an  earlier  developmental  phase. 

1  Any  given  Bymptom  is  ordinarily  a  condensation  product  cor- 
responding to  the  attempted  realization  of  several  unconacioiui 
phantasicBi  not  aU  of  which  are  necessarily  infantile  nor  for  that 
matter,  even  sexual,  though  the  central  ones  are  usually  both. 

When  I  say  that  the  neurosis  attempts  to  realize  the  now  un- 
conscious phantasies  corresponding  to  the  abandoned  masturba- 
tion of  puberty,  I  hope  this  may  not  be  construed  to  mean  that 
masturbation  either  directly  or  indirectly  oaused  the  neurosis. 
One  could  more  truthfully  say  that  it  was  not  the  masturbation 
but  the  giving  it  up  which  caused  the  neurosis,  inasmuch  as  it  is 
the  damming  up  of  the  libido  and  not  its  gratification  which 
produces  neurotic  disease.  Both  the  phantasies  attending  the 
masturbation  and  the  neurosis  have  a  common  ''cause"  for  they 
eicpress  the  tame  trends.  Masturbation  is  normal  or  abnormal 
in  youth  according  to  whether  it  expresses  normal  or  abnormal 
wish  constellations. 

Cp.  Freud:  Hyeterioai  Fancies  and  Their  Relation  to  Biaea^ 
uality  in  ''Selected  Papers  on  Hysteria  and  Other  Psychoneuroses," 
Chapter  IX. 


240    MORBID  FEARS  AND  COMPULSIONS 

Bat  the  neurosis  is  not  only  an  attempt  to  grat- 
ify, after  the  manner  of  the  old  hallndnatory 
method,  wishes  belonging  to  the  ITnconsdons 
which  are  returning  from  repression.  It  may  also 
serve  to  secure  gratification  for  other  and  even 
conscious  wishes  and  not  through  essentially  phan- 
tastio  but  through  real  means.  The  first  form  of 
wish  fulfillment  Freud  calls  the  primary  function 
of  the  neurosis,  the  latter  its  secondary  fxmotion. 
For,  at  least  in  any  cases  of  long  standing,  the 
neurotic  fises  his  illness  as  a  means  or  instrument 
to  various  ends.  Though  when  the  neurosis  first 
breaks  out,  it  is  regarded  by  the  patient  as  wholly 
a  calamity,  he  begins  at  length  to  make  capital 
out  of  it,  after  the  manner,  as  Freud  expresses  it, 
of  a  workman  who,  having  lost  his  legs  in  an  acci- 
dent, becomes  a  street  beggar,  thereby  converting 
what  was  at  first  wholly  a  loss  into  an  important 
business  asset.  The  neurotic  takes  advantage  of 
his  illness  to  gain  attention,  sympathy  and  love, 
to  avoid  things  disagreeable,  to  revenge  himself 
on  others,  or  to  punish  himself  and  do  penance  for 
what  he  conceives  to  be  his  sins.  And  just  as  a 
legless  mendicant  with  a  well  established  begging 
business,  who  has  become  adjusted  to  a  life  of  that 
sort  and  forgotten  the  trade  by  which  he  originally 
earned  his  bread,  might  hesitate  to  take  advantage 
of  the  opportunity,  should  he  find  his  legs  could 
miraculously  be  restored ;  so  the  neurotic  is  loath 
to  give  up  what  the  neurosis  gains  for  him,  and  the 
more  it  wins  him  through  its  secondary  function 
the  greater  will  be  his  resistance  against  the 


MORAL  STRUGGLE  241 

analysis  or  any  other  procedure  which  seeks  to 
bring  about  a  cure. 

In  pointing  out  that  the  neurosis  is  a  wish  reali* 
zation  from  the  side  of  the  unconscious  part  of  the 
personality,  we  must  not  lose  sight  of  its  other 
aspect,  namely  that,  considered  from  the  point  of 
view  of  th^  upper  strata,  consciousness  and  the 
f oreconscious,  it  is  a  defense.  It  signifies  a  with- 
drawal from  and  a  denial  of  facts  that  are  dis- 
agreeable, a  purposive  blindness  to  what  the 
patient  does  not  want  to  see.  For,  whatever  an 
individual's  conscience,  standards  or  ideals  may 
be  (and  in  this  respect  persons  differ  enormously) 
the  trends  from  the  Unconscious  which  are  seek- 
ing expression  are  of  the  very  sort  which,  accord- 
ing to  his  lights,  are  the  most  undesirable  to  have, 
and  the  most  painful  and  mortifying  to  acknowl- 
edge. The  neurosis  is  thus  an  effort  to  maintain 
the  individual's  narcissistic  satisfaction  or  self 
esteem ;  a  sort  of  self-deception  which  attempts  to 
treat  as  if  non-existent  whatever  trends  in  his 
make-up  are  uncongenial  and  would  lower  him  in 
his  own  eyes.  It  tries  to  prevent  the  displeasure 
which  results  from  the  i)erception  of  a  disparity 
between  the  real  self  and  the  ideal  set  for  the  self 
by  denying  that  there  is  any  disparity.  These 
resistances,  at  the  same  time,  are  an  expression 
of  the  ethical  part  of  the  personality,  and  reflect 
a  moral  struggle  and  an  effort  on  the  part  of  the 
individual  to  be  what  he  thinks  he  ought  to  be,  a 
yearning  to  live  up  fully  to  his  own  ideals.  Some 
who  read  reports  of  analyzed  cases  get  the  impres- 


242    MOBBID  FEABS  AND  COMPULSIONS 

sion  that  the  neurotics  are  by  nature  exceptionally 
immoral  or  even  unmoral  people.  But  this  is  be- 
cause the  analysis  is  particularly  devoted  to  the 
study  of  the  unmoral  (instinctive)  tendendes. 
The  truth  is  that  neurotics  are  very  moral  people 
(too  moral,  perhaps)  despite  the  fact  that  their 
behavior  would  not  in  every  instance  appear  to 
confirm  such  a  statement.  Compared  with  the 
average  normal  people  their  moral  impulses  are 
unusually  strong  and  compelling.  For  whatever 
they  do  that  is  not  moral,  they  have  to  pay  in  re- 
morse and  self-reproaches  to  a  d^^ee  which,  in 
spite  of  all  their  displacements  and  defensive 
mechanisms,  exceeds  that  which  the  ordinary  per- 
son suffers  for  any  equivalent  misconduct 

If  it  now  be  asked  what  is  the  immediate  cause 
for  the  regression  of  the  libido  and  introversion 
which  is  manifested  by  the  breaking  out  of  a  neu- 
rosis, no  better  way  of  reply  can  be  found  than  by 
quoting  at  length  from  Freud's  illuminating  paper 
on  this  subject.* 

^^The  cause  of  neurotic  illness  easiest  to  find 
and  understand  is  that  external  factor  which  may 
be  described  as  deprivation.  The  individual  is 
healthy  as  long  as  his  need  of  love  is  satisfied  by  a 
real  object  in  the  external  world ;  he  becomes  neu- 
rotic as  soon  as  this  object  is  taken  away  from  him, 
without  his  finding  a  substitute  for  it.  Fortune 
and  health,  misfortune  and  neurosis  here  coincide. 
A  cure  is  brought  about  more  easily  by  fate,  which 

1  Freud:  Ueher  die  neurotisohen  Erkrankung9Pype»,  Zentral* 
blatt  f.  Psychoon.  Bd.  II.,  1912»  pages  297-302. 


DEPEIVATION  243 

may  send  a  substitate  for  the  lost  possibility  of 
satisfaction,  than  by  the  physician. 

'^In  this  type,  which  inclndes  the  majority  of 
people,  the  possibility  of  disease  therefore  begins 
only  with  abstinence,  a  fact  from  which  one  may 
estimate  how  significant  the  cultural  limitations 
upon  accessible  satisfaction  may  be  in  the  etiology 
of  the  neurosis.  Deprivation  acts  pathologically 
because  of  the  fact  that  it  dams  up  the  libido  and 
so  puts  the  individual  to  the  test  of  how  long  he 
can  endure  this  increased  psychic  tension  and 
what  course  he  will  pursue  to  free  himself  from  it. 
There  are  only  two  possibilities  of  remaining 
healthy  in  a  long  continued  actual  deprivation  of 
satisfaction,  first  that  of  transforming  the  psychi- 
cal tension  into  kinetic  energy  which  continues  to 
be  directed  towards  the  external  world  and  finally 
forces  from  it  a  real  satisfaction  of  the  libido ;  sec- 
ond, that  of  renouncing  the  love  satisfaction  and 
sublimating  the  dammed  up  libido  by  turning  it  to 
attainable  aims  which  are  no  longer  erotic.  That 
both  possibilities  are  actually  found  in  the  fate  of 
mankind  shows  us  that  misfortune  is  not  abso- 
lutely coincident  with  neurosis  and  that  depriva- 
tion is  not  the  only  deciding  factor  for  the  health 
or  illness  of  the  individual.  The  result  of  de- 
privation is  primarily  that  it  brings  into  action 
the  previously  latent  dispositional  factors. 

''Where  these  are  sufficiently  strong,  there  is  a 
danger  that  the  libido  will  become  introverted. 
It  turns  away  from  reality,  which  on  account  of  its 
obstinate  denial  has  lost  interest  for  the  indi- 


244    MORBID  FEABS  AND  COMPULSIONS 

vidnal^  tarns  to  the  life  of  phantasies,  where  it 
creates  new  wish  formations  and  revivifies  the 
traces  of  earlier,  forgotten  ones.  As  a  result  of 
the  intimate  interdependence  of  the  phantasy 
activity  and  the  repressed  and  nnconscions  infan- 
tile material  existing  in  every  individual,  and  by 
virtue  of  the  fact  that  phantasy  activity  is  ex- 
empted from  having  to  conform  to  reality,^  the 
libido  can  revert  further,  find  infantile  channels 
by  way  of  regression  and  strive  toward  the  aims 
corresponding  with  thent  When  these  strivings, 
which  are  incompatible  with  the  actual  circum- 
stances of  the  individual^  have  gained  enough 
intensity,  there  must  occur  a  conflict  between 
them  and  the  other  part  of  the  personality,  which 
has  retained  its  true  relations  to  reality.  This 
conflict  is  compromised  by  symptom  formations 
and  comes  out  as  a  manifest  illness.  That  the 
whole  process  comes  from  the  actual  deprivation 
is  shown  by  the  fact  that  the  symptoms,  with 
which  the  level  of  reality  is  again  attained,  are 
substitute  satisfactions. 

**The  second  type  of  the  exciting  cause  for  the 
illness  is  not  at  all  as  obvious  as  the  first,  and  as  a 
matter  of  fact  may  be  discovered  only  by  penetrat- 
ing study  in  conjunction  with  the  'doctrine  of 
complexes '  of  the  Zurich  *  school.  Here  the  indi- 
vidual becomes  ill  not  as  a  result  of  a  change  in 
the  external  world,  which  has  put  deprivation  in 

iPormulienmgen  Aber  die  ztoei  Prineipim  det  fityohiwhm 
Ge§dieh6n9,  Jahrb.  f.  PsychoanalTBey  Bd.  III. 

s  Jung:  Die  Bedeuiwi^f  dee  Vatere  fUr  doe  Sehiekeal  dee  Bkh 
telnet^  Jahrb.  f.  Paychoanalyae,  I»  1909. 


DEPRIVATION  245 

the  place  of  satisfaction,  but  as  the  result  of  a 
fruitless  effort  to  get  the  satisfaction  which  is 
accessible  in  the  world  of  reality.  He  becomes  ill 
in  the  attempt  to  adapt  himself  to  reality,  and  to 
fulfill  the  demands  of  reality,  an  attempt  in  which 
he  meets  with  insurmountable  internal  di£Sculties. 

''It  is  desirable  to  distinguish  the  two  types  of 
illness  sharply  from  each  other,  more  sharply  than 
observation  generally  permits.  In  the  first  type 
a  change  in  the  external  world  is  the  prominent 
feature,  in  the  second,  the  emphasis  falls  on  the 
internal  change.  According  to  the  first  type  one 
falls  ill  of  an  experience,  according  to  the  sec- 
ond, of  a  developmental  process.  In  the  first  case 
there  is  set  the  task  of  doing  without  a  satisfac- 
tion, and  the  individual  falls  ill  of  his  inability  to 
endure  the  privation ;  in  the  second  case  the  task 
is  to  exchange  one  kind  of  satisfaction  for  another, 
and  the  person  is  wrecked  by  its  difficulty.  In  the 
second  case,  the  conflict  between  the  effort  to  re- 
main as  one  is  and  the  effort  to  change  oneself 
according  to  new  designs  and  new  requirements  of 
reality  exists  from  the  beginning;  in  the  first  case 
it  arises  only  after  the  dammed  up  libido  has 
chosen  new  and  at  the  same  time  unacceptable 
modes  of  satisfaction.  The  roles  of  the  conflict 
and  the  early  fixations  of  the  libido  are  incom- 
parably more  striking  in  the  second  type  than  in 
the  first,  where  such  impracticable  fixations  arise 
only  as  the  result  of  the  external  deprivation. 

"A  young  man  who  has  previously  satisfied  his 
libido  by  phantasies  terminating  in  masturbation, 
and  now  wants  to  exchange  this  regime,  so  near 


246    MORBID  FEARS  AND  COMPULSIONS 

to  autoerotism,  for  real  object  love ;  a  girl  who  has 
given  her  father  or  her  brother  her  entire  affection 
and  now  in  her  relations  with  her  lover  ought  to  ad- 
mit into  consciousness  the  previously  unconscious, 
incestuous  libido  wishes;  a  married  woman  who 
desires  to  give  up  her  polygamous  tendencies  and 
prostitution  phantasies,  in  order  to  be  a  true  wife 
to  her  husband  and  a  blameless  mother  to  her  chil- 
dren— ^all  these  fall  ill  of  the  most  praiseworthy 
efforts,  if  the  earlier  fixations  of  their  libido  are 
strong  enough  to  resist  a  displacement,  a  matter 
in  which  disposition,  constitutional  make-up  and 
infantile  experience  are  the  deciding  factors.  In 
a  way  they  all  suffer  the  fate  of  the  little  tree  in 
Grimm's  fairy  tale,  that  wanted  to  have  other 
leaves.  From  the  hygienic  standpoint,  which  to 
be  sure  is  here  not  the  only  one,  one  could  but  wish 
that  they  still  had  remained  as  undeveloped,  as 
inferior  and  as  irresponsible  as  they  were  before 
their  becoming  ill.  The  change  which  the  patients 
strive  for,  but  produce  only  incompletely  or  not  at 
all,  has  regularly  the  value  of  progress  in  the  sense 
of  the  real  life.  It  is  another  matter  if  one 
measures  them  with  an  ethical  standard.  One 
sees  that  people  quite  as  often  fall  ill  if  they  wish 
to  give  up  an  ideal  as  if  they  wish  to  attain  it. 

**  Despite  the  very  significant  differences  be- 
tween the  two  types  of  becoming  ill,  they  yet  coin- 
cide essentially  and  are  easily  reduced  to  a  unity. 
Falling  ill  from  deprivation  also  comes  under  the 
heading  of  a  failure  to  adapt  to  reality,  in  the  case, 
for  example,  where  reality  refuses  satisfaction  of 
the  libido.    Falling  ill  under  the  conditions  of  the 


INTEOVEESION  247 

second  type  reduces  to  a  special  case  of  depriva- 
tion. In  it  not  every  form  of  satisfaction  by 
reality  is  withheld,  bat  merely  the  one  which  the 
individual  insists  is  the  only  one  for  him,  and  the 
deprivation  comes  not  directly  from  the  external 
world,  but  primarily  from  certain  strivings  of 
the  ego.  The  deprivation  remains  the  common 
element.  As  a  result  of  the  conflict  which  imme- 
diately takes  place  in  the  second  type,  both  kinds 
of  satisfaction,  the  accustomed  and  the  newly 
striven  for,  are  inhibited.  This  amounts  to  a 
damming  up  of  the  libido  with  the  same  results 
which  follow  it  in  the  first  case.  The  psychic 
processes  on  the  path  to  symptom  formation  in 
the  second  type  are  rather  clearer  than  in  the  first, 
as  the  pathogenic  fixations  of  the  libido  had  not 
first  to  be  established  here  but  had  been  in  force 
during  the  period  of  apparent  health.  A  certain 
degree  of  introversion  of  the  libido  already  ex- 
isted; a  part  of  the  regression  to  the  infantile  is 
dispensed  with  by  the  fact  that  the  development 
did  not  have  to  travel  bade  over  the  entire  way. 

**The  next  type  which  I  will  describe  as  a  be- 
coming sick  through  an  arrest  of  development, 
appears  as  an  exaggeration  of  the  second  type, 
the  falling  ill  through  the  demands  of  reality. 
There  is  no  theoretical  requirement  for  differenti- 
ating them,  but  there  is  a  practical  one,  since  it  is 
a  question  of  persons  who  fall  Ul  as  soon  as  they 
leave  the  irresponsible  age  of  childhood  and  there- 
fore have  never  reached  a  phase  of  health,  i.  e.  of 
a  wholly  unlimited  efficiency  and  well  being.  The 
essentials  of  the  disposing  process  are  quite  clear 


248    MORBID  FEARS  AND  COMPULSIONS 

in  these  cases.  The  libido  has  never  abandoned 
the  infantile  fixations,  the  demands  of  reality  do 
not  suddenly  burst  upon  the  partly  or  wholly 
mature  individual,  but  arise  from  the  fact  of  be- 
coming older,  for  quite  obviously  they  continu- 
ously change  with  the  age  of  the  individual  The 
factor  of  conflict  here  recedes  before  that  of  de- 
fect, and  yet,  according  to  all  our  other  views  we 
must  assume  an  effort  to  overcome  the  fixations  of 
childhood,  otherwise  the  issue  of  the  process  could 
not  be  a  neurosis  but  only  a  stationary  infantilism. 
''As  the  third  type  has  shown  us  the  dispo- 
sitional factor  almost  isolated,  the  fourth,  which 
now  follows,  calls  our  attention  to  another  which 
plays  a  rdle  in  all  cases,  and,  for  that  very  reason, 
might  be  overlooked  in  a  theoretical  discussion. 
Thus  we  see  individuals  falling  ill  who  were  well 
previously,  but  to  whom  no  new  experience  has 
occurred,  and  whose  relation  to  the  external  world 
has  suffered  no  change,  so  that  their  falling  ill 
must  impress  us  as  being  spontaneous.  Closer  ex- 
amination of  such  cases  shows  us  that  a  change  has 
taken  place  in  them  nevertheless,  and  one  which 
we  must  consider  of  the  greatest  significance  in 
the  causing  of  illness.  As  a  result  of  attaining  a 
certain  period  of  life  and  in  connection  with  reg- 
ular biological  processes,  the  quantity  of  libido  in 
their  spiritual  economy  has  had  an  increase  which 
of  itself  is  enough  to  upset  the  balance  of  health 
and  produce  the  conditions  for  a  neurosis.  Suek 
rather  sudden  increases  of  libido  are  familiar  and 
are  regularly  connected  with  puberty  and  meno- 
pause, and  the  attainment  of  a  certain  age  in 


DAMMING  UP  OF  LIBIDO  249 

women.  In  many  men  ihey  may  be  manifested 
also  in  still  unknown  periodicities.  The  dam- 
ming up  of  the  libido  is  the  prime  factor  here ;  it 
becomes  pathogenic  as  a  result  of  the  relative 
deprivation  on  the  part  of  the  external  world, 
which  would  still  permit  the  satisfaction  of  more 
limited  demands  of  the  libido.  The  unsatisfied 
and  dammed  up  libido  can  open  the  path  to  regres- 
sion and  kindle  the  same  conflicts  which  we  have 
posited  for  the  absolute  external  denial.  We  are 
thus  reminded  that  we  should  not  lose  sight  of  the 
quantitative  factor  in  any  consideration  of  the 
etiology  of  the  illness.  All  other  factors  (depri- 
vation, fixation,  arrest  of  development),  remain 
without  effect  if  they  do  not  relate  to  a  definite 
measure  of  libido  and  cause  a  damming  up  to  a 
definite  height.  This  quantity  of  libido  which 
seems  to  us  requisite  for  a  pathogenic  effect,  is  of 
course  not  measurable.  We  can  postulate  it  only 
after  the  illness  has  taken  place.  In  only  one  di- 
rection can  we  estimate  it  more  closely;  we  may 
assume  that  we  are  not  dealing  with  an  absolute 
quantity  but  with  the  relation  of  the  actual  amount 
of  libido  to  that  quantity  of  libido  which  the  indi- 
vidual ego  can  control,  i.  e.  maintain  in  tension, 
sublimate  or  directly  apply.  Therefore  a  relative 
increase  of  libido  quantity  may  have  the  same 
effect  as  an  absolute  one.  A  weakening  of  the 
ego  by  organic  disease  or  by  a  special  requisition 
upon  its  energy  is  able  to  cause  neuroses  which 
otherwise  would  have  remained  latent  in  spite 
of  any  disposition. 
^^The  significance  in  the  causation  of  the  illness 


250    MOEBID  FEARS  AND  COMPULSIONS 

which  we  must  grant  to  the  quantity  of  the  libido 
agrees  very  well  with  the  two  main  principles  of 
the  doctrine  of  the  nearoses  which  have  been 
gained  from  psychoanalysis.  First  with  the  prin- 
ciple that  the  neuroses  arise  out  of  the  conflict 
between  the  ego  and  the  libido,  second  with  the 
view  that  there  is  no  qualitative  difference  between 
the  conditions  of  health  and  neurosis,  that  the 
healthy  have  to  struggle  much  more  vigorously 
with  the  task  of  controlling  the  libido,  but  that 
they  succeed  better. 

'^It  still  remains  to  say  a  few  words  about  the 
relation  of  these  types  to  experience.  When  I 
think  over  the  patients  whom  I  am  just  now  an- 
alyzing, I  must  say  that  none  of  them  is  a  pure 
example  of  any  one  of  the  four  types  of  falling  ilL 
I  rather  find  in  each  one  of  them  a  bit  of  depriva- 
tion operative  alongside  of  a  partial  inability  to 
adapt  to  the  demands  of  reality.  The  concept  of 
arrest  of  development,  which  coincides  indeed  with 
the  rigidity  of  the  fixations,  comes  into  view  in 
all,  and  we  can  never  neglect  the  significance  of 
the  quantity  of  the  libido,  as  before  mentioned. 
Indeed  I  learn  that  in  several  of  these  patients 
the  illness  has  appeared  in  installments,  between 
which  were  intervals  of  health,  and  that  each  one 
of  these  installments  may  be  reduced  to  a  different 
type  of  causation.  The  putting  forward  of  these 
four  types  has  therefore  no  great  theoretical 
value ;  they  are  merely  different  ways  of  establish- 
ing a  certain  pathojgenic  constellation  in  the 
spiritual  domestic  economy,  namely  the  damming 


CAUSATION  251 

up  of  the  libido,  against  which  the  ego,  with  the 
means  it  has,  cannot  protect  itself  without  injury. 
The  situation  is  in  itself  pathogenic  only  by  vir- 
tue of  the  quantitative  factor;  it  is  not  a  novelty 
introduced  into  the  mental  life  by  the  intrusion  of 
a  so-called  'cause  of  disease.' 

''A  certain  practical  significance  we  gladly  con- 
cede to  these  types  of  falling  ill.  In  individual 
cases  they  may  be  observed  in  their  pure  state. 
We  should  not  have  noticed  the  third  and  fourth 
type,  if  they  had  not  contained  the  only  causes 
for  the  illness  of  many  individuals.  The  first 
presents  to  us  the  extraordinarily  powerful  in- 
fluence of  the  external  world;  the  second,  the  no 
less  significant  role  of  the  make-up  of  the  individ- 
ual which  resists  this  influence.  Pathology  can- 
not give  the  correct  solution  to  the  problem  of 
the  cause  of  the  disease  as  long  as  it  concerns 
itself  merely  with  the  distinction  of  whether  these 
affections  are  of  endogenous  or  exogenous  nature. 
Against  all  experiences  which  point  to  the  signifi- 
cance of  abstinence  (in  the  broadest  sense)  as  the 
cause  it  must  always  raise  the  objection  that  other 
persons  suffer  the  same  fate  without  falling  ill. 
But  if  pathology  emphasizes  the  idiosyncracy  of 
the  individual  as  the  essential  for  Ulness  and 
health,  then  it  neglects  the  fact  that  persons  with 
such  peculiarity  may  remain  healthy  for  a  very 
long  time,  as  long  as  they  are  permitted  to  retain 
it.  Psychoanalysis  has  suggested  our  giving  up 
the  fruitless  antithesis  of  external  and  internal 
factors,  environment  and  constitution,  and  has 


252    MOEBID  PBABS  AND  COMPULSIONS 

taught  xiA  regularly  to  find  the  cause  of  the  nea- 
rotio  disturbance  in  a  definite  psychic  situation 

which  may  be  produced  in  various  ways/' 

•         ••••••• 

While  we  still  have  in  mind  the  question  of  the 
damming  up  of  the  libido,  it  may  be  well  to  enter 
into  some  general  considerations  concerning  a 
common  result  of  this  damming  up^  namely  mor- 
bid fear  or  ^^ anxiety,"  a  symptom  which,  as  Jones 
remarks,  is  undoubtedly  the  most  frequent  one  in 
the  whole  realm  of  psychopathology.^ 

First  let  us  ask  what  is  the  difference  between  a 
fear  that  is  morbid  and  a  normal  fear.  In  the 
quality  of  the  emotions  themselves  there  is  noth- 
ing which  would  invariably  distinguish  them. 
Though  in  morbid  fears  there  is  often  a  prepon- 
derance of  the  physical  manifestations,  this  is  by 
no  means  invariably  the  case.  Nor  is  the  intens- 
ity of  the  emotion  a  definite  index.  Morbid  fears 
are  usually  more  intense  than  any  fears  that  a 
normal  person  suffers  under  ordinary  circum- 
stances, but  situations  of  great  danger  can  pro- 
duce perfectly  normal  fears  which  are  quite  as 
intense  as  any  morbid  ones.  What  really  dis- 
tinguishes the  two  sorts  of  fears  is  the  fact  that, 
as  Jones  points  out,  a  morbid  fear  is  a  relatively 
excessive  one.^  It  occurs  on  occasions  where  a 
normal  person  would  either  feel  no  fear  at  all  or 

iThe  word  anxiety,  as  lued  in  pflycboanalytic  writing,  has 
aboQt  the  same  aignificanoe  as  the  German  word  Angst,  i.e.,  an 
intense  fear.  The  words  fear  and  anxiety  are,  however,  often  need 
interchangeably. 

s  Jones:  "Pathology  of  Morbid  Anxiety*'  in  his  Papen  on  Pm^ 


MORBID  FEAB  253 

else  a  less  intense  one.  An  additional  fact  is  that 
normal  fears  are  nsually  short  in  duration,  while 
morbid  ones  may  be  very  persistent.  None  of 
these  criteria  is,  however,  absolute.  The  basic 
difference  between  a  morbid  and  a  normal  fear  is 
one  of  origin,  and  this  is  not  revealed  to  superfidal 
observation.  A  normal  fear  is  a  reaction  to  an 
external,  material  situation  or  condition  of  which 
the  individual  is  clearly  aware.  A  morbid  fear, 
on  the  other  hand,  has  its  real  source  in  an  in- 
ternal and  psychic  situation,  of  which  the  individ- 
ual is  unconscious.  The  external  stimulus  which 
evokes  an  attad:  of  morbid  fear  is  not,  as  the 
patient  may  think,  the  cat^e  of  the  emotion,  but 
merely  serves  as  a  cue  to  set  off  a  reaction  which 
has  its  real  source  elsewhere. 

The  essential  cause  of  morbid  anxiety  or  fear  is 
a  damming  up  of  the  libido.  The  fear  is  an  over- 
flow phenomenon,  the  result  of  the  pent  up  energy 
forcing  a  way  of  escape  despite  opposition  or  re- 
pression. The  dammed  up  wish-energy  which  the 
repression  withheld  from  action  now  breaks  out 
as  feeling.  The  effect  of  the  repression  has  been 
to  transform  this  energy  into  fear.  Morbid  fear, 
in  other  words,  is  really  desire — ^in  the  broad 
sense,  sexual  desire — ^which  various  inhibitions 
have  diverted  from  more  natural  channels  of  ex- 
pression. 

That  morbid  anxiety  really  results  from  desire 
seems,  at  first  thought,  hardly  credible.  A  wish 
and  a  fear  are  so  utterly  unlike  in  their  qualities 
that  it  seems  impossible  that  ever  under  any  cir- 
cumstances the  one  could  be  the  cause  of  the 


254    MOBBID  FEABS  AND  COMPULSIONS 

other.  Nevertheless,  the  more  we  become  ae- 
qnainted  with  the  facts  relating  to  the  sltoatioii, 
the  less  improbable  aU  this  seems. 

Let  us  ask  what  an  emotion  is,  and  see  if  this 
does  not  throw  some  light  on  the  question.  An 
emotion,  one  mig^t  say,  is  an  undischarged  action, 
a  deed  yet  retained  within  the  organism.  Thus 
anger  is  an  unf ought  combat ;  fear  an  unfled  flight. 
Perhaps  it  would  be  more  accurate  to  say  that  an 
emotion  is  a  state  of  preparedness  for  action, 
which  however  in  many  ways  is  almost  the  action 
itself.  The  involuntary  nervous  system  is  exdted 
in  the  same  way  as  in  action.  The  same  changes 
take  place  in  the  blood.  A  state  of  tonus  is  pro- 
duced in  the  same  voluntary  muscles  that  would 
be  innervated  to  produce  the  action  itself.  Thus 
Grile  writes:  '^ There  is  (in  emotion)  a  specific 
stimulation  or  inhibition  of  every  organ  and  tissue 
in  the  body,  in  accordance  with  the  rdle  each  is  to 
play  in  the  intended  adaptive  muscular  response. 
Blood  is  transferred  from  the  parts  non-essential 
to  muscular  action  (the  stomach,  intestines  and 
genital  system)  and  concentrated  upon  the  ma- 
chinery necessary  to  muscular  action  (the  heart, 
lungs,  central  nervous  system  and  skeletal 
muscles).  The  drcnlation  is  accelerated,  metabo- 
lism is  increased,  the  production  of  waste  prod- 
ucts is  at  its  maximum,  the  breath  comes  faster, 
the  heart  beats  quickly,  the  skin  is  moist  from 
excessive  perspiration,  the  limbs  tremble,  the  ex- 
tremities tingle,  every  detail  of  the  intended 
muscular  action  is  simulated.''^    The  organism 

iCrile:  '"Man,  an  Adaptiye  Mecbaniam.'* 


EMOTION  255 

is  like  a  car  which,  with  throttle  open,  spark  ad- 
vanced and  engine  racing,  throbs  and  trembles 
with  liberated  energy,  while  the  dutch  which  shall 
connect  this  power  with  the  locomotor  machinery 
is  not  yet  thrown  in.  The  identity  of  emotion  and 
action  goes  so  far  that,  as  Crile  points  out,  strong 
feeling  results  in  the  same  fatigae  phenomena 
(subjective  and  objective  signs  of  exhaustion, 
histologic  changes  in  various  organs)  that  would 
result  from  the  exertion  itself.  In  short,  emotion 
is  the  same  as  action  in  practically  every  respect, 
save  that  of  massive  movement. 

But  what  is  of  particular  interest  is  the  fact 
that,  as  shown  by  Cannon,  by  Crile  and  by  others, 
there  take  place,  in  strong  emotion,  characteristio 
chanfes  in  the  blood  content  which  anticipate  and 
prepare  for  great  exertion,  such  as  that  of  combat 
or  flight.  Iodized  protein,  Crile  thinks,  is  thrown 
out  in  abnormal  amounts  from  the  thyroid  in 
strong  emotion  and  has  the  effect  of  sensitizing 
the  organism  by  facilitating  the  passage  of  elec- 
trical currents  through  semi-permeable  mem- 
branes, and  so  lowering  the  threshold  to  all  stim- 
uli, and  increasing  the  energy  transformation. 
As  Cannon  showed,  there  is  an  increased  amount 
of  sugar  furnished  to  the  blood,  which  increases 
the  capacity  of  the  muscles  for  work  and  thus  pre- 
pares for  struggle  or  flight.  Similarly  as  he 
demonstrated  there  is  an  increased  output  of 
adrenin,  which  not  only  aids  in  bringing  out  sugar 
from  the  liver's  store  of  glycogen,  but  has  the 
property  of  restoring  to  fatigued  muscles  the  same 
readiness  for  response  which  they  had  when  fresh. 


256    MORBID  FEARS  AND  COMPULSIONS 

It  has  the  further  effect  of  constricting  vessels  in 
such  parts  of  the  body  that  are  not  active  in  exer- 
tion and  thus  driving  the  blood  to  those  regions 
where  in  strong  effort  it  is  most  needed.  It  also 
relaxes  the  muscle  fibers  in  the  bronchioles  and 
favors  respiration  as  in  preparation  for  great 
effort*  The  clotting  time  of  the  blood  is  at  the 
same  time  decreased  as  if  to  prepare  for  the  pos- 
sible wounds  that  might  come  in  the  course  of 
combat. 

The  emotion^  from  the  point  of  view  of  physi- 
ology,  is  these  various  preparatory  changes  in  the 
content  of  the  blood,  in  the  innervation  of  the 
various  muscles,  endocrine  glands  and  other 
viscera.  The  emotion,  from  the  point  of  view  of 
psychology,  is  the  afferent,  sensory  report  of  these 
changes.  Thus,  as  James  epigrammatically  ex- 
pressed it,  we  are  afraid  because  we  tremble,  not 
that  we  tremble  because  we  are  afraid.^ 

One  is  accustomed  to  think  of  sexual  emotion,  or 
excitement,  as  being  something  essentially  very 
different  from  all  other  emotion,  say  anger  or  fear, 
and  so  it  is  from  the  subjective  side.  On  the  other 
hand,  from  the  physiological  point  of  view,  it  is 
not  so  different  as  one  might  expect.  In  fact  it 
can  be  shown  that  these  states  of  sexual  tension 
and  of  fear  are  so  closely  related  that  it  need  not 
be  considered  surprising  that  one  merges  into  the 
other— i.  e.  that  a  condition  of  tension  or  prepared- 

1  William  James:  'Trindplea  of  Paydiology,"  Vol.  I,  page  450. 

The  state  of  tension  or  tonus,  which,  according  to  the  ehannela 
along  which  it  is  expressed,  is  either  emotion  or  action,  is  the 
physiological  equivalent  of  what  in  Freudian  psychology  is  spoken 
ol  as  the  unconscious  wish. 


SEXUAL  EMOTION  257 

11688  which  is  primarily  sexaal  can  give  the  sub- 
jective report  of  fear.  But  to  show  this  is  as  far 
as  one  can  go  at  present  Our  knowledge  is  insuf- 
ficient to  explain  why,  under  some  circumstances, 
a  damming  up  of  libido  mttst  be  felt  as  fear  and 
what  are  the  exact  details  of  the  process.  We 
have  to  be  content  with  knowing  that  this  relation- 
fihip,  which  clinical  observation  demonstrates  cer< 
tainly  to  exist,  is,  on  physiological  grounds,  well 
within  the  bounds  of  the  eventually  explicable. 

Popular  opinion  would  regard  sexual  emotion 
or  excitement  as  conditioned  mainly  by  an  accumu- 
lation of  semen  in  the  testicles.  This  notion  is 
obviously  incorrect,  for  sexual  excitement  occurs 
in  children  long  before  there  is  any  seminal  secre- 
tion, in  males  castrated  after  puberty  and  in 
women,  who  have  no  specific  external  sexual  secre- 
tion. About  the  same  sort  of  objection  applies  to 
the  theory  that  sexual  excitement  is  wholly  de- 
pendent on  accumulations  of  internal  secretions 
from  the  specifically  sexual  glands.  In  short,  the 
sexual  secretions,  either  internal  or  external, 
probably  are  not  the  chief  immediate  basis  for 
sexual  excitement,  but  at  most  supply  only  its 
specific  factors. 

Cannon,  Crile  and  others  seem  to  think  that 
there  occur  in  sexual  emotion  the  same  blood 
changes  anticipatory  of  exertion  that  take  place 
for  other  emotions,  namely  an  increase  of  thyroid 
products,  of  adrenalin,  of  sugar,  etc.  It  is  per- 
haps, then,  not  unreasonable  to  think  that  sexual 
excitement  has  both  specific  and  non-specific  com- 
ponents.   The  specific  factors  would  very  likely 


258    MOEBID  FEARS  AND  COMPULSIONS 

indude  the  aoctunnlatlons  of  internal  secretions 
of  the  seznal  glands,  and  the  stimnli  repres^ited 
by  the  pressure  of  seminal  secretion  upon  the 
walls  of  its  receptacles.  Most,  if  not  all  of  them, 
would  come  into  play  only  in  adult  sexuality. 
The  non-spedfio  elements  would  be  changes  in  the 
blood  content  and  in  the  sympathetic-autonomic 
balance,  much  the  same  as  tiiose  that  prepare  for 
any  sort  of  vigorous  action  or  exertion  such  as 
attack  or  flight 

Sexual  emotion,  tension  or  preparedness  is  less 
dependent  on  external  stimulation  than  are  other 
normal  emotions.  We  do  not  feel  continuous  nor- 
mal anger  or  fear  unless  we  are  continuously  sub- 
ject to  an  external  menace.  But  sexual  tension 
or  preparedness  may  arise  in  the  absence  of  any 
external  stimulation  and  tends  to  persist  until 
relieved  by  some  suitable  action,  of  which  coitus, 
in  the  adult,  is  normally  the  most  satisfactory  one. 
Thus,  in  the  absence  of  actions  adequate  in  quality 
or  in  frequency  to  discharge  the  libido,  there  may 
come  about  a  state  of  organic  sexual  preparedness 
which  is  chronic.^  In  other  words  a  lack  of  ade- 
quate sexual  outlet  (and  by  this  is  not  meant 
simply  abstinence  from  intercourse)  may  result  in 
an  accumulation  in  the  blood  of  abnormal  quanti- 
ties of  thyroid  bodies  and  perhaps  of  sugar, 
adrenin  and  other  substances  which  constitute  an 
important  part  of  the  state  of  preparedness  for 
non-sexttdl  exertion  such  as  attack  or  flight,  and 
this  very  likely  is  accompanied  by  corresponding 

1  ThiB  does  not  mean  that  the  indiTidoal  need  be  oontinuoiisly 
0OMoiott«  of  sexual  desire. 


ANXIETY  STATES  259 

changes  in  the  sympathetiG-autonomio  balance.  It 
is  not  then  difficult  to  imagine  that  this  accnmnla- 
tion  and  these  changes  in  the  involnntary  nervous 
system  which  have  so  much  in  common  with  the 
states  of  preparedness  from  which  come  the 
afferent  reports  known  as  anger  and  f ear,  could 
reach  such  a  point  as  either  to  create  abnormally 
low  threshold  and  exaggerated  reaction  to  slight 
occasions  for  normal  anxiety  or  fear  (e.  g.,  an  ex- 
cessive anxiety  over  what  would  normally  be  a 
matter  for  slight  worry)  or  even  give  the  afferent^ 
report  of  fear  (or  anger)  in  the  absence  of  any 
special  external  stimulus.^ 
^.  Certainly  the  clinical  facts  are  in  accord  with 
this  hypothesis.  In  1895  Freud  wrote  a  paper 
describing  a  condition  which  had  formerly  bi^en 
classed  as  one  of  the  varieties  of  '^ Neurasthenia" 
which  he  named  Anmety  Neurosis.*  The  symp- 
toms were  (1)  general  irritability  and  hyperes- 

1  It  cannot  be  advanced  as  an  objection  to  this  hypotbeaU  tbat 
if  a  damniTiig  up  of  tbe  libido  can  cause  fear  it  also  ougbt  to 
cauae  anger,  for  tbe  reaaon  tbat,  in  certain  caaea,  it  doe9  catue 
anger  (or  at  least  an  over  intense  reaction  to  wbat  in  normal 
persons  would  cause  but  sligbt  irritation).  Tbe  constant  state 
of  irritability,  exasperation  or  ill  temper  (in  abort,  of  cbronic 
anger)  wbicb  is  manifest  in  some  nervous  people  is  so  familiar 
as  bardly  to  require  comment.  Wby  a  damming  up  of  tbe  libido 
abould  more  frequently  cause  fear  tban  anger  is  a  question  tbat 
cannot  yet  be  answered  more  tban  to  say  tbat  conditions  of  in- 
bibition  or  repression  wbicb  are  usually  in  part  responsible  for 
tbe  damming  up  are  surely  closely  allied  to  fear;  wbile  anger 
more  nearly  coincides  witb  tbe  freer  or  self-assertive  state  of 
mind  tbat  leads  to  or  goes  witb  an  adequate  sexual  outlet 

s  Ueher  die  Berechiigung  wm  der  Neuraaihenie  einm^  hettimm' 
ien  Bymptomen-homplem  ala  **Ang9tn€uro9e^  ahMtrennen.  Brill's 
translation  appears  in  "Seleeted  Papers  on  Hysteria  and  Otber 
Piycboneuroses. 


260    MOEBID  PEAES  AND  COMPULSIONS 

thesia,  (hyperacasis,  insomnia,  etc),  (2)  anxions 
expectation,  fearfuInesSi  worry,  with  perhaps 
ocoasional  severe  attacks  or  seizures  of  intense 
anxiety,  and  (3)  somatic  symptoms  such  as  dis- 
turbances of  heart  action,  attacks  of  dyspncea,  of 
sweating,  trembling,  vertigo  or  diarrhoea. 

This  condition  Freud  considered  an  ''Actual 
Neurosis''  (as  distinguished  from  a  psycho-neu- 
rosis, an  essentially  psychic  disease)  which  arose 
under  such  conditions  as  lead  to  ''an  accumula- 
tion of  somatic  sexual  excitement"  which  had  not 
been  allowed  to  become  elaborated  into  psychic 
excitement  or  to  obtain  adequate  discharge. 
Conditions  such  as  those  of  voluntary  sexual  ab- 
stinence, the  practice  of  coitus  interruptus  or 
reservatus,  or  the  failure  of  gratification  in  the  i 
woman  which  results  from  premature  ejaculation 
on  the  part  of  the  man,  he  found  to  be  typical  for 
its  causation.  The  establishment  of  a  better 
regime  (for  instance,  the  substitution  of  coitus 
condomatus  for  coitus  interruptus)  which  made 
full  sexual  gratification  possible,  had  in  many 
cases  the  effect  of  removing  all  symptoms. 

These  symptoms  which  Freud  describes  indi- 
cate very  dearly  the  presence  of  the  endocrine  fac- 
tors and  correlated  disturbances  of  the  sympa- 
thetic nervous  system.^  The  condition  of  general 
irritability  (i.e.  of  lowered  threshold  and  too 

1  Freud  has  pointed  out  the  resemblance  of  the  physical  ae* 
oon^wniments  of  the  anxiety  attacks  to  those  of  sexual  excite- 
ment— ^rapid  heart  action,  hurried  breathing,  perspiration,  dry* 
ness  of  the  mouth,  involuntary  muscular  oontractionsy  etc  They 
also  resemble  those  of  angry  excitement. 


ANGEE  AND  HATE  261 

ready  response  to  fiH  sorts  of  stimnli)  is  what  we 
expect  from  an  abnormal  amount  of  thyroid  secre- 
tion in  the  blood.  It  is  altogether  like  that  which 
occurs  with  Graves's  disease  (a  condition,  by  the 
way,  in  which  morbid  anxiety  is  often  a  promi- 
nent symptom)  or  can  be  produced  by  the  admin- 
istration of  thyroid.  The  palpitation,  diarrhoeal 
attacks  and  other  symptoms  are  apparently  the 
same  as  those  occurring  with  hyperthyroidism  of 
other  origin.  The  vaso-motor  symptoms  and  oth- 
ers referable  to  the  sympathetic  nervous  system 
might  indicate  the  presence  of  an  excessive  secre- 
tion of  adrenalin  or  might  be  the  effect  of  thyroid 
bodies  themselves.  (Elliott^  asserts  that  adren- 
alin can  produce  every  result  of  stimulation  of  the 
sympathetic  nervous  system  except  an  increase  in 
the  secretion  of  adrenalin.) 

Anger,  hate  and  the  impulses  to  overcome  or 
attack  blend  with  the  sexual  sadistic,  aggressive 
and  self-assertive  reactions,  while  fear  and  the 
impulses  to  submission  or  flight  are  likewise 
shaded  into  the  masochistic  reactions.  The  sadis- 
tic impulses  and  the  combative  or  destructive  im- 
pulses were  doubtless  identical  early  in  phylo- 
genetic  history,  if  not  indeed  in  the  ontogenetic. 
We  know  how  readily,  either  in  animals  or  in  man, 
a  state  of  anger  or  the  act  of  attacking  may  be 
converted  by  relatively  slight  changes  in  the 
incoming  stimuli  into  fear  or  flight,  and  vice  versa. 
It  is  not  so  very  strange,  then,  if  we  find  the 
energy  corresponding,  in  the  broad  sense,  to 
sexual  excitations  or  tensions  shifting  from  pro- 

1  Quoted  by  CannoiL 


262    MOEBID  FEAES  AND  COMPULSIONS 

gressive  or  aggressive  manifestations  and  becom- 
ing fear  in  much  the  same  manner  as  rage  or  anger 
may  readily  become  fear.  Coitus,  as  many  have 
said,  is,  in  a  way,  an  overcoming,  a  struggle,  a 
combat,  and  this  might  prepare  us  for  the  fact  .that 
the  impulses  thereto,  and  particularly  those  that 
have  their  somatic  fulcrum  in  the  voluntary  mus- 
cular system,  imdergo  the  same  shifts  and  trans- 
formations as  do  those  of  anger  and  combat  which 
are  designed  for  self-preservation. 

At  any  rate,  and  however  we  explain  it,  there 
is  abundant  and  incontrovertible  evidence  that 
dammed  up  forces  corresponding  to  inhibited,  or 
ungratified,  or  undischarged  impulses  that,  in  the 
broad  sense,  we  must  call  sexual,  do  certainly 
result  in  fear.  Perhaps  for  all  practical  pur- 
poses we  have  sufficient  explanation  in  the  follow- 
ing principles  suggested  (in  a  somewhat  different 
connection)  by  Spencer.  **  It  is  an  unquestion- 
able truth  that,  at  any  moment,  the  existing  quan- 
tity of  liberated  nerve  force,  which  in  an  inscrut- 
able way  produces  in  us  the  state  we  call  feeling, 
mt^st  expend  itself  in  some  direction — ^must  gen- 
erate an  equivalent  manifestation  of  force  some- 
where. ' '  *  *  Overflow  of  nerve  force,  undirected  by 
any  motive,  will  manifestly  take  the  most  habitual 
routes ;  and,  if  these  do  not  suMce,  will  next  over- 
flow into  the  less  habitual  ones.'^^  *  In  short,  the 
holophilic  energy  (and  by  this  is  meant  not  simply 
the  desire  for  coitus),  if  denied  an  adequate 
natural  outlet,  sublimated  or  otherwise,  will  force 

tH.  Spencer:  "Essays,  Scientific,  Political,''  etc.,  quoted  by  Dar- 
win in  his  "Expression  of  the  Emotions." 


FEAB  263 

for  itself  an  mmatural  one.  It  '^must  expend 
itself  somewhere. ' '  ^ 

So  much  for  the  physiological  aspects  of  the 
question.  Let  ns  now  look  at  it  from  the  psycho- 
logical point  of  view.  The  biological  function  or 
purpose  of  fear  is  protective  or  preservative. 
Every  one  of  us  alive  to-day  owes  his  existence  to 
the  fact  that  his  human  and  prehuman  ancestors 
were  afraid.  It  has  often  been  stated  that  the 
human  skin^  with  its  acute  sensitiveness  to  pain, 
is  a  better  protective  medium  than  the  enormously 
thick  and  tough  hide  of  the  rhinoceroSi  or  the  bony 
casing  of  the  armadillo.  In  the  same  sense  it  may 
be  said  that  a  readiness  to  fear  is  as  valuable  a 
protection  as  the  poison  fangs  of  the  serpent  or 
the  strength  of  the  elephant.*  That  is  to  say,  fear 
constitutes  an  insurance  for  the  preservation  of 
the  animal  or  species  by  compelling  withdrawal 
from  situations  that  threaten  injury  or  death,  or 
by  prohibiting  approach  to  such  situations. 

It  hardly  seems  probable  that  in  morbid  fear 
the  emotion  has  lost  this  biological  significance. 
At  most  we  should  expect  that  there  could  be  only 
a  miscarriage  of  it.  Normal  fear,  however,  is 
provoked  only  by  external  conditions  or  objects. 

iWe  cannot  eyen  attempt  to  explain  on  a  phyBiological  basis 
why  morbid  fear  attaches  itself  to  certain  special  objecsts  and  not 
to  others. 

s  As  Crile  points  oat,  animals  like  the  rabbit,  antelope,  horse, 
monkey  and  man,  which  depend  for  self-preservation  on  a  swift 
locomotor  reaction,  exhibit  fear  and  an  irrepressible  impulse  to 
flee  from  danger.  The  skimk,  however,  whose  chief  means  of 
protection  is  its  odor;  the  porcnpine,  defended  by  its  quills;  the 
tiurtle,  protected  by  its  shell;  the  lion  and  the  elephant,  secure 
in  their  superior  strength,  show  little  if  any  fear. 


264    MORBID  FEAES  AND  COMPULSIONS 

Morbid  fear  has  origin  from  conditions  that  are 
internal.  This  seems  to  ns  something  entirel7 
noveL  Nevertheless  it  is  not.  We  have  seen 
that  in  infancy  there  is  no  accurate  distinction 
made  between  the  ego  and  the  non-ego.  A  similar 
state  of  affairs  may  also  exist  in  adult  life.  Ob- 
jects or  persons  really  external  are  felt  as  a  part 
of  the  self  (identification)  while  processes  really 
belonging  to  the  individual's  own  psyche  are  per- 
ceived as  influences  arising  from  without  (pro- 
jection). This  really  is  the  expression  of  a  gen- 
eral principle.  That  is  to  say^  the  ego  has  a  tend- 
ency to  treat  all  sources  of  pleasure,  whether  they 
be  internal  or  external,  as  a  part  of  the  self  (for 
instance,  the  identification  that  comes  with  love) ; 
while  to  all  sources  of  pain  or  displeasure,  whether 
they , are  inner  or  outer,  it  tends  to  react  as  if  they 
were  hostile  and  a  part  of  the  external  world.^ 
That  the  ego  can  react  to  really  endopsychic 
processes  or  conditions  as  if  they  were  external 
and  hostile  is  really  then  no  absolute  novelty  to  us. 
Morbid  fear  seems  to  occur  according  to  the 
principle  just  stated.  Though  it  is  justifiable  to 
speak  of  morbid  fear  clinically  as  being  converted 
libido,  this  may  not  be  entirely  accurate,  as  Jones 
points  out.*  The  morbid  fear  is  perhaps  not  the 
libido  itself,  converted,  but  rather  a  fear  reaction 
against  the  libido.  That  is,  the  repressed  libido, 
striving  for  forms  of  wish-fulfiUment,  which  from 
the  point  of  view  of  the  individual's  conscious  and 

1  Compare  Freud's    "Triebe  and  TriebwhlckBale,"  Int.  Zdtaehr. 
1  Arzt  Pgychoanalyse,  Vol.  111, 1916. 
sL.  c. 


FEAB  AND  DESIRE  265 

f oreconscions  trends,  are  repugnant  and  would 
cause  displetisure,  is  treated  like  other  sources 
of  displeasure,  as  something  external  and  hos- 
tUe,  and  so  provokes  the  protective  reaction  of 
fear. 

The  prayer:  '^Lead  us  not  into  temptation"  in 
a  certain  sense  implies  that  the  individual  is 
afraid  of  his  own  desires.  We  often  hear  it  said 
that  a  certain  man  is  his  own  worst  enemy,  which 
means  that  his  welfare  is  menaced,  as  through  a 
hostile  influence,  by  wishes  that  are  really  his  own. 
In  morbid  fear  it  is  as  if  such  a  statement  were 
taken  literally,  and  the  individual  reacts  to  what 
is  really  a  part  of  himself  as  if  to  an  enemy. 
When  a  woman,  finding  herself  in  danger  of  being 
forced  to  have  intercourse  with  a  strange  man, 
reacts  with  fear,  we  call  the  emotion  normal.  If, 
however,  the  impulse  that  threatens  to  force  her 
into  sexual  relations  with  a  stranger  is  her  own 
dammed  up  libido,  and  the  danger  is  thus  one  that 
arises  primarily  from  within,  we  call  the  fear  ab- 
normal, though  in  each  case  the  impending  experi- 
ence which  she  dreads  is  exactly  the  same. 

Morbid  fear  is  then  an  excitation  of  the  normal 
/  fear  instinct  provoked,  however,  by  the  individ- 
ual's own  sexual  impulses,  which,  breaking 
through  the  control  of  the  higher  psychic  systems, 
threatens  to  become  a  menace.  Naturally  the 
more  powerful  the  unruly  impulses  and  the  greater 
the  failure  of  repression,  the  more  intense  will  be 
the  morbid  fear.  In  one  sense  morbid  fear  is  not 
morbid  at  all.    It  is  rather  a  normal  reaction  to 


266    MOEBID  FEABS  AND  COMPULSIONS 

the  danger  arising  from  an  ahnormcX  conditum-— 
the  damming  np  of  the  libido  to  a  point  where  it 
breaks  through  f  oreconsdoos  control. 

As  I  have  pointed  out  elsewhere,  the  existence 
of  a  causal  relationship  between  desire  and  fear 
has  not  everywhere  been  unsuspected,  even  before 
Freud.  Certain  writers  such  as  Krafift-Ebing, 
Nystrom,  Bohleder,  Eisch,  Leyden  ^  have  noticed 
that  sexual  abstinence  resulted  in  states  of  anxiety 
and  nervousness.  There  has  also  been  some  pop- 
ular recognition  of  this  fact.  I  have  used  the  fol- 
lowing story  to  bring  out  the  latter  point. 

The  traditional  Miss  Antique  came  to  the  board- 
ing house  table  one  night  in  a  state  of  great  exdte- 
ment.  *  *  Oh, ' '  she  cried,  *  *  I  Ve  had  such  an  experi- 
ence t  Just  now  as  I  was  coming  home  through  a 
dark  and  lonely  street  I  saw  a  Man!  And,  My 
Goodness,  how  I  did  runl'' 

'^ You  don't  say  so  1''  returned  one  of  the  board- 
ers, looking  up  with  an  expression  of  sympathetic 
interest,  '^and  did  you  catch  him.  Miss  Antique!'' 

To  illustrate  the  point  in  question  this  story 
does  not  have  to  be  true.  Women  of  the  sort  it 
describes  unquestionably  do  exist.  And  their  ex- 
aggerated fear  of  men  has,  in  other  instances  than 
that  of  the  cynical  boarder,  been  correctly  inter- 
preted as  an  over  compensation  for  unsatisfied 
desire.* 

We  have  offered  two  explanations  of  the  origin 
of  neurotic  fear  from  dammed  up  desire,  a  physio- 

1  See  H.  EUie:  "Sex  and  Society.'' 

>  Fielding  and  Dickeno,  among  other  writers,  show  a  keen 
Insight  into  defensive  reactions  of  about  this  sort. 


FEAB  AND  DESIRE  267 

logical  and  a  psychologioal  one.  The  latter  seems 
to  me  the  more  satisfactory  and  perhaps  the  best 
substantiated.  As  a  matter  of  fact  it  is  probable 
that  both  are  correct.  In  one  case  what  we  would 
call  the  strictly  physiological  factors  may  predom- 
inate, and  the  psychic  ones  in  the  next,  while  both 
are,  in  varying  degrees,  involved  in  alL 

This  may  be  paralleled  with  the  fact  that  morbid 
fear  cases  may  have  two  types  of  origin.  In  one 
the  damming  up  of  the  libido  results  primarily 
from  physical  factors,  in  the  other  mainly  from 
psychic  ones.  Where  the  essentially  physical 
factors  form  the  starting  point  (as  for  instance 
where  coitus  interruptus,  or  premature  ejacu- 
lation on  the  part  of  the  husband,  leaves  the 
woman  ungratified)  the  symptoms  may  be  done 
away  with  by  establishing  a  better  regime  (coitus 
condomatus  in  place  of  coitus  interruptus)  which 
allows  the  woman  ^s  gratification  to  be  completed. 
A  damming  up  which  arises  as  the  result  of  psy- 
chic factors  (repressions,  resistances  and  con- 
flicts) is  not  noticeably  affected  by  any  alteration 
of  the  physical  factors  in  the  sex  life. 

Pure  cases  of  the  anxiety  neurosis,  which  corre- 
spond to  the  first  type  of  origin,  and  which,  when 
Freud  first  described  the  condition,  he  regarded  as 
an  '^ actual"  neurosis  (a  non-psychogenic  mal- 
ady), probably  do  not  exist.  It  now  seems  quite 
certain  that  even  in  those  cases  where  the  physical 
factors  interfering  with  discharge  of  the  libido 
are  the  primary  and  significant  ones,  psychic  con- 
flicts come  into  play  secondarily  and  have  a  rdle 
in  the  formation  of  the  symptoms— conflicts  which. 


268    MOEBID  FEABS  AND  COMPULSIONS 

however,  may  subside  as  soon  as  the  physical  pri- 
mary factors  are  properly  attended  to.  But  the 
anxiety  neurosis  nevertheless  remains  as  a  valu- 
able concept,  and  represents  a  real  condition,  even 
though  it  cannot  be  observed  clinically  in  a  pure 
state.  The  anxiety  neurosis  is  now  included 
within  the  term  anxiety  hysteria,  which  at  one 
time  was  reserved  for  those  cases  where  primarily 
physical  factors  played  no  important  role.  It 
may  be  added,  however,  that  even  in  the  cases 
which  are  most  truly  "psychical,'*  the  physiolog- 
ical element  of  endogenous  intoxication  by  reten- 
tion of  secretions  is  without  doubt  always  present 
and  has  a  definite  role.^ 

In  the  hope  of  correcting  certain  false  impres- 
sions that  may  have  arisen  in  the  course  of  this 
discussion,  let  us  again  warn  against  taking  the 
word  sexual  in  a  too  narrow  sense,  and  regarding 
genital  sexuality  as  the  whole  of  sex.  When  we 
say  that  for  health  any  individual  requires  an 
adequate  sexual  outlet,  it  must  be  understood  that 
this  outlet  may  be  secured  in  a  great  number  of 
different  ways.  A  person  may  be  having  regular 
and  frequent  sexual  intercourse  (excessive  inter- 
course, in  fact)  without  this  affording  him  an  ade- 
quate outlet  or  preventing  his  libido  from  becom- 
ing dammed  up.  On  the  other  hand,  another  per- 
son may  not  be  having  intercourse  at  all,  and  yet 
his  sexual  outlet  be  entirely  adequate,  for  he  can 
work  off  most  of  his  libido  through  sublimations 

iCf.  Jones:  'The  Relation  Between  the  Anxiety  Neurosis  and 
Anxiety  Hysteria/'  JourwU  of  Almormal  Pwychology^  Vol.  VIII, 
1918. 


SEXUAL  OUTLET  269 

and  in  aims  that  of  themselves  are  not  erotic  If 
all  that  is  required  for  an  adequate  sexual  outlet 
were  frequently  repeated  orgasms^  then  masturba- 
tion would  cure  every  neurosis. 


CHAPTER  VI 

THE  PSYOHOLOGY  OF  THB  COMFUI^IOK 

NEX7B0SIS 

OT  very  long  ago  practically  all  neurotic 
disturbances  which  on  the  one  hand  were 
not  manifest  cases  of  hysteria  nor  on  the 
other  of  major  psychoses,  were  as  a  rale  grouped 
indiscriminately  under  the  one  designation  of 
Neurasthenia.  Though  this  easy  if  slipshod  diag- 
nostic practice  is  not  yet  entirely  done  away  with, 
even  among  neurologistSi  nevertheless  most  neu- 
rologists and  psychiatrists  now  clearly  recognize 
that  what  was  formerly  called  neurasthenia  really 
comprises  several  distinct  disease  entities  differ- 
ing from  one  another  in  clinical  characteristics 
and  pathological  structure,  and  that,  as  applied 
to  most,  if  not  all  of  them,  the  term  neurasthenia 
is  a  dedded  misnomer.  For  most  of  these  con- 
ditions are  not,  strictly  speaking,  nerv(yus  disor- 
ders at  all.  They  are  states  of  mind,  psycholog- 
ical disturbances ;  and  the  nerves,  as  such,  are  not 
immediately  involved  in  their  pathology.  The 
term  "nerve  weakness,**  whether  in  Englisli  or 
Greek,  is  therefore  a  poor  name  to  apply  to  them. 
A  group  of  cases  most  obviously  purely  psycho- 
logical and  among  the  first  to  be  recognized  as  such 
are  those  which  Janet  rescued  from  the  diagnostic 
waste  basket  and  designated  by  the  name  psy- 

270 


PSYCHASTHENIA  271 

chasthenia.  They  comprise  the  variously  called 
obsessions,  fixed  ideas,  morbid  fears  (phobias) 
doubts,  compulsions  and  impulsions.  Later  ob- 
servations, particularly  those  by  Freud,  resulted 
in  the  division  into  two  groups  of  these  cases 
which  Janet  included  under  the  one  term  psychas- 
thenia.  One  contains  certain  fear  states  or  ^'pho- 
bias" of  which  agoraphobia  is  a  type,  and  is  desig- 
nated by  Freud  as  anxiety  hysteria.  The  other  is 
now  usually  known  as  the  comt)ulsion  (or  obses* 
sional)  neurosis.  We  shall  b^gin  with  a  consider- 
ation of  the  latter  condition. 

Let  us  study  some  examples.  A  man  killed  a  fly 
which  annoyed  him  by  buzzing  about  the  room. 
Hardly  had  he  done  so  when  there  came  to  him 
the  thought,  accompanied  by  an  intense  feeling  of 
horror  and  fear :  ^^My  God,  what  if  I  should  kill  a 
person  like  that!''  He  was  not  conscious  of  ever 
having  had  a  desire  to  Mil  any  one;  he  was  not 
really  in  fear  that  he  ever  would  kill  any  one,  but 
nevertheless  the  thought  ^^But  wouldn't  it  be 
awful  if  I  didf "  stuck  in  his  mind  for  months  at  a 
time  and  he  was  utterly  unable  to  banish  it. 

A  young  married  woman,  who  happened  to  be 
watching  another  woman  who  was  seated  at  a 
window  across  the  street,  suddenly  discovered  that 
she  could  not  get  the  thought  of  tiiis  other  woman 
out  of  her  mind.  She  hctd  to  think  of  her,  she  did 
not  know  why  nor  to  what  end,  but  she  could  not 
stop  it.  These  thoughts,  accompanied  by  a  sense 
of  apprehension  and  depression,  persisted  for  the 
greater  part  of  the  time  for  four  or  more  years. 
These  two  cases  are  examples  of  what  are  known 


272    MORBID  PEABS  AND  COMPULSIONS 

variously  as  compulsive  ideas,  fixed  ideas  or  ob- 
sessions. 

An  intelligent  yonng  Jewish  girl,  who  was  her- 
self not  at  all  superstitious,  was  induced  by  a  rela- 
tive to  consult  a  fortune  teller  in  reference  to  a 
love  affair.  Shortly  afterwards  she  was  sud- 
denly seized  with  a  terrific  fear  that  the  fortune 
teller  was  exerting  some  sort  of  magical  speU  over 
her  and  that  as  a  result  she  would  go  insane.  She 
knew  this  was  perfect  nonsense,  yet  the  fear  con- 
tinued to  force  itself  upon  her  with  remarkable 
intensity  and  she  was  absolutely  powerless  to 
drive  it  from  her  mind.  (Obsessive  or  compul- 
sive fear.) 

A  young  woman,  whenever  she  uses  the  word 
"I'*  is  tormented  by  the  question  "Who  is  It 
What  is  it!''  To  use  or  to  hear  the  word  "My" 
has  a  similar  effect.  "Who  is  Myf  she  has  to 
ask  herself.  "Jfy  is  not  my  body  or  I  wouldn't 
say  ^my  hands.'  It's  not  my  mind  or  I  wouldn't 
say  'wy  mind.'  Who  or  what  then  is  it!"  She 
felt  continually  impelled  to  ask  other  people  these 
questions,  and  many  had  tried  to  answer  them  or 
convince  her  that  they  were  unanswerable,  but  to 
no  avail.  "I've  got  to  know  I"  she  would  say. 
"I  must  find  out.  I  never  can  rest  until  I  do." 
All  the  time  she  suffered  from  a  tense,  anxious 
feeling  which,  it  seemed  to  her,  could  be  relieved 
only  by  her  finding  the  answers  she  sought. 
(Compulsive  thinking,  Ombelsucht) 

A  boy  in  high  school  was  supplied  with  some 
second  hand  books.  He  began  to  doubt  the  accu- 
racy of  them,  for,  as  they  were  not  new,  he  thought 


COMPULSIONS  273 

they  might  be  out  of  date,  and  what  he  read  might 
not  be  the  truth.  Before  long  he  would  not  read 
a  book  unless  he  could  satisfy  himself  that  it  was 
new  and  the  writer  of  it  an  authority.  Even  then 
he  was  assailed  with  doubts.  For  he  felt  uncer- 
tain as  to  whether  he  understood  what  he  read. 
If  for  example  he  came  across  a  word  of  which  he 
was  not  sure  of  the  exact  meaning,  he  could  not  go 
on  until  he  had  looked  up  the  word  in  a  dictionary. 
But  as  likely  as  not  in  the  definition  of  the  word 
there  would  be  some  other  word  with  which  he  was 
not  entirely  familiar  and  he  would  have  to  Ibok 
that  up,  so  that  at  times  half  an  hour  or  more 
would  be  taken  up  in  reading  a  single  page,  and 
even  then  he  would  feel  doubtful  as  to  whether  he 
had  gotten  the  exact  truth.  (Compulsive  doubt.) 
A  young  woman  was  impelled  at  frequent  inter- 
vals to  rip  up  her  clothes  and  make  them  over 
again,  feeling  that  she  could  improve  their  fit. 
Another  was  forced  to  eat  bread  in  enormous 
quantities.  Still  another  had  to  count  ten  before 
every  contemplated  action  and  then  while  carry- 
ing out  the  action  she  would  have  to  tell  herself 
what  it  was  she  was  doing.  Thus  if  she  were  go- 
ing out  she  would  have  to  say:  **Now  I  am  put- 
ting on  my  hat ;  now  I  am  opening  the  door ;  now 
I  am  going  down  the  steps ;  now  I  am  turning  the 
comer,  etc.'^  Before  beginning  each  of  these 
actions  she  would  have  to  count  ten.  These  are 
oases  of  compulsive  or  obsessive  actions.  In 
each  case  the  patient  had  to  obey  the  impulse  in 
question.  An  effort  to  resist  it  invariably  re- 
sulted in  an  unbearable  sense  of  tension  and 


V 


J 


274     MORBID  PEARS  AND  COMPULSIONS 

anxiety  which  was  relieved  only  when  the  act  was 
carried  out. 

Now  what  feature  have  these  cases  in  common 
to  be  classed  as  compulsions?  In  what  does  a 
compulsion  consist? 

From  the  point  of  view  of  the  patient  the  term 
compulsion  is  accurately  descriptive  of  his  own 
feeling  with  regard  to  his  symptoms.  The  com- 
pulsive idea,  fear  or  impulse,  as  the  case  may  be, 
appears  in  his  consciousness  as  something  foreign 
which  is  forced  upon  him  as  if  from  without. 
There  is  to  him  a  sense  of  must-ness  which  invests 
the  compulsive  activities.  He  is  compelled  to 
think,  to  fear  or  to  act  in  a  eeiriain  definite  way, 
although  his  reason  and  his  inclinations  are  op- 
posed to  his  so  doing. 

From  the  point  of  view  of  the  observer  the 
essential  fact  of  a  compulsive  symptom  would 
appear  to  consist  in  a  mesalliance  between  affect 
and  idea-content.  This  mesalliance  is  most  com- 
monly quantitative.  The  emotion  or  impulse  ap- 
pears altogether  excessive  for  its  ideational  ac- 
companiment. The  fear  of  the  young  woman  that 
the  fortune  teller  was  driving  her  insane  by  means 
of  magic  might  not  have  seemed  excessive,  had  she 
really  believed  that  he  had  that  power,  but  as  a 
matter  of  fact  she  did  not  believe  it,  and  was  quite 
convinced  that  he  was  merely  an  ignorant  char- 
latan. Thus  the  amount  of  her  fear  was  entirely 
disproportionate  to  her  ideas  of  the  thing  feared. 
In  the  same  way  it  was  quite  reasonable  for  the 
high  school  boy  to  wish  to  assure  himself  that  the 
books  he  studied  were  reliable  and  that  he  under- 


COMPULSIONS  275 

stood  what  he  read,  but  his  feeling  in  the  matter 
was  altogether  excessive  in  proportion  to  the  like- 
lihood of  his  receiving  any  serions  misimpression 
either  through  inaccuracy  of  his  books  or  a  failure 
to  understand  all  the  words  he  read. 

There  may  also  be  a  qualitative  disharmony  in 
addition  to  a  purely  quantitative  incongruity  be- 
tween the  affective  and  idea  content  of  a  compul- 
sive symptom.  Such  was  the  case  in  the  example 
of  the  patient  who  could  not  stop  thinking  about 
the  woman  across  the  street.  There  was  a  quan- 
titative incongruity  inasmuch  as  the  woman  across 
the  street  was  a  perfect  stranger  and  there  was  no 
apparent  reason  why  the  patient  should  have  any 
emotion  about  her  at  all.  But  the  kind  of  feeling 
which  accompanied  her  thoughts  was  also  qualita- 
tively unsuitable,  for  there  seemed  to  be  nothing 
in  the  woman's  appearance  or  the  patient's  con- 
scious knowledge  of  her  to  account  for  the  fact 
that  thinking  of  her  gave  rise  to  apprehension  and 
gloouL 

It  would  seem,  on  approaching  the  matter  as 
we  have  done,  that  the  chief  problem  presented* 
by  compulsive  phenomena  is  that  of  explaining 
the  lack  of  accord  between  affect  and  idea.  If. 
the  considerations  represented  by  the  idea-con- 
tent of  a  compulsive  symptom  are  obviously  in- 
adequate to  account  for  its  emotional  content,  we 
feel  then  that  we  must  account  for  the  emotional 
content  in  some  other  way.  It  would  seem, 
short,  that  the  affects  must  have  some  othe 
source  than  that  represented  by  the  ideas  to  whic 
they  are  attached.    But  if  in  pursuance  of  this' 


276    MOEBID  FEABS  AND  COMPULSIONS 

hypofhesis  we  ask  of  a  patient:  ^^Is  there  any- 
thing in  yonr  life  that  troubles  you,  or  that  could 
give  rise  to  the  strong  emotions  of  which  yon 
complain? "  he  replies:  ' 'No,  nothing  at  alL  If 
I  could  only  get  this  terrible  fear  out  of  my  nund, 
I'd  have  nothing  else  to  bother  me,  and  I'd  be 
perfectly  happy  and  well."  In  the  face  of  such 
an  answer,  unless  we  are  willing  to  abandon  our 
hypothesis  entirely,  we  are  forced  to  condade 
either  that  the  patient  is  lying  or  that  he  does 
not  know* 

But  with  these  last  words  he  does  not  know  we 
have  hit  upon  the  truth  of  the  matter.  If  we  were 
acquainted  with  every  detail  of  the  patient's  men- 
tal life,  it  would  at  once  be  plain  that  there  are 
most  adequate  reasons  for  the  strong  affects  in 
question,  but  that  he  was  not  fully  aware  of  them, 
that  they  were  partly  unconscious.  Or  we  might 
find  that  though  he  was  conscious  of  the  causes 
of  the  strong  affects,  he  was  not  conscious  of  them 
as  causes  of  these  affects,  that,  in  other  words, 
he  did  not  recognize  the  connection  between  the 
affect  and  its  cause.  The  apparent  dispropor- 
tion between  affective  and  ideational  content  in 
the  compulsion  would  then  be  seen  to  be  due  to 
the  fact  that  the  affects  had  been  attached  to 
the  wrong  ideas.  Of  the  right  group  of  ideas 
(those  in  full  accord  with  the  affects)  he  had 
been  at  best  only  dimly  conscious  while  the  con- 
nection of  these  ideas  with  the  '' morbid"  impulse 
and  emotion  he  had  not  recognized  at  alL^  In 
other  words,  to  seek  to  explain  the  phenomena 

1  Thii  fact  alone  goes  a  long  way  toward  explaining  why  logic 


COMPULSIONS  277 

of  the  compulsion  on  the  basis  only  of  what  the 
patient  is  aware  of  is  really  to  seek  the  impossible. 
Their  true  significance  does  not  appear  until  we 
bring  the  symptoms  into  relation  with  certain 
motives,  wishes  and  considerations  of  which  the 
patient  has  not  complete  comprehension  and  con- 
Bcionsness. 

Such  a  word  as  ** Unconscious**  or  ** Subcon- 
scious'' as  applied  to  mental  processes  for  most 
people  smacks  of  the  transcendental  and  the  un- 
real. It  seems  to  them  hard  to  believe  that  ideas 
or  impulses  which  are  more  or  less  unconscious 
can  at  the  same  time  be  significant  and  exert  a 
potent  influence  in  the  individual's  conscious  life 
and  conduct.  And  it  often  appears  particularly 
hard  to  believe  that  unconscious  or  unrecognized 
thoughts  produce  symptoms,  that  is  to  say  pain- 
ful effects,  sickness  and  suffering.  '^If  there  is 
anything  in  a  person's  life  bad  enough  to  make 
him  sick,  surely  he'd  know  all  about  it"  I  once 
heard  a  prominent  physician  say,  and  this  remark 
expresses  a  quite  general  feeling  in  regard  to  the 
matter. 

But,  as  a  matter  of  fact,  all  of  us,  even  those 
who  have  been  most  vehement  in  denying  the  real- 
ity or  significance  of  unconscious  mental  proc- 
esses^ do  in  a  way  recognize  both  their  existence 
and  their  potence  in  determining  human  conduct, 
and  we  frequently  interpret  the  behavior  of  our 
acquaintances  upon  such  a  basis.  How  often,  for 
instance,  do  we  hear  some  such  statement  as  this : 

and  reason  are  powerless  to  dispel  obsessions.  Such  attempts 
cannot  be  directed  to  the  real  (unconscious)  cause. 


278    MOBBID  FEABS  AND  COMPULSIONS 

'^Stokes  thinks  he  is  in  love  with  Miss  Bhodes, 
hut  I'm  sore  he  isnt.  It's  really  her  money  he's 
marrying  her  for,  hut  he  doesn't  know  it."  And 
what  does  such  a  statement  imply,  if  not  that 
Stokes  is  swayed  hy  a  powerful  motive  of  whioih 
he  is  not  vividly  conscious  f  Who  has  not  made 
remarks  containing  similar  implications? 

Even  the  physician  quoted  ahove,  who  does  not 
'^helieve  in"  the  Unconscious,  gave  evidence  of  a 
keen  appreciation  of  the  potence  of  the  non-con- 
scious factors  in  determining  behavior.  Com- 
menting upon  a  woman  who  had  suddenly  dis- 
played a  fanatical  and  obviously  neurotic  enthusi- 
asm and  activity  in  the  cause  of  woman  suffrage, 
he  said:  ''It  isn't  a  vote  that  she  wants."  His 
meaning,  obviously  enough,  was  that  what  she 
did  want  was  a  man,  and  that  her  feverish  activity 
in  behalf  of  ''the  Cause"  was  really  the  product 
of  repressed  longings  the  reality  and  nature  of 
which  she  was  unwilling  to  recognize  and  admit 
— ^longings  which  were,  in  part  at  least,  uncon- 
scious. 

It  is  hardly  to  be  denied  then  that  an  impulse 
or  an  idea  does  not  have  to  be  a  clearly  compre- 
hended and  conscious  one  in  order  to  be  of  sig- 
nificance in  the  life  of  the  individual  Conse- 
quently the  statement  that  the  real  causes  of  the 
apparently  exaggerated  affects  in  the  compulsion 
neuroses  are  for  the  most  part  unrecognized  or 
unconscious  is  not  really  so  much  at  variance 
with  every  day  experience  as  perhaps  it  first  ap- 
peared. 

It  is  now  to  be  asked  what  the  reason  is  that  the 


PAETIAL  BEPRESSION  279 

forces  causing  the  compulsive  symptoms  are  not 
apprehended  by  the  patients.  What  is  it  that 
prevents  them  from  being  aware  of  the  factors 
that  are  really  at  workf  We  had  a  hint  of  the 
answer  to  sudi  questions  from  the  two  examples 
of  unconscious  influence  that  have  been  given. 
For  in  both  cases  it  will  be  noted  that  the  unrec- 
ognized trend  was  of  a  nature  which  the  individ- 
ual would  have  been  rather  reluctant  to  admit  of 
possessing  or  giving  in  to.  And  if  one  searches 
his  memory  for  similar  cases,  as  furnished  by  the 
behavior  of  his  acquaintances,  he  is  quite  cer- 
tain to  find  this  feature  common  to  all.  Such  is 
the  explanation  of  why  the  neurotic  patient  does 
not  know  the  nature  of  the  forces  producing  his 

compulsions.      "R^nr    ^n    fli<>    Tnair    ^^^^nn    iTnpnlnnft^ 

(and  their  repr.esjBnting  ideiBts)  ar.e.i)f  Hunh  a  kind 

and  contrary  to^or  out  of  accord  witji^thejjr^nds^ 
of  hifl.athical  self.  The  lack  pf  knasdedge  is  a 
result  of  the  automatic  ceBsoisliip  -eitorciaod  -l^ 
consciousness  and  the  foreconscious, — ^an  effect 
of  r^ression. 

But,  as  has  been  many  times  indicated,  the 
fact  that  a  wish  is  out  of  consciousness  does  not 
mew  that  It  has  ceased  to  exist.  Repression  is 
not  annihilation.  A  wish  which  is  repressed  may 
persist  in  the  Unconscious  entirely  unchanged  in 
quality  or  intensity  and  in  no  way  differing  from 
a  conscious  wish  save  in  the  one  particular  that  the 
individual  has  ceased  to  have  awareness  of  it. 

A  neurosis  is  then  a  partial  failure  of  repres- 
aion.    The  repressed  elements  in  such  a  case  are 


280    MOEBID  FEARS  AND  COMPULSIONS 

neither  completely  excluded  from  consdonsness 
nor  have  they  wholly  free  entrance  into  it.  What 
happens  is  that  the  repressed  forces  again  mani- 
fest themselves  in  consoiousnessi  not,  however  in 
their  original,  hut  in  a  disguised  and  distorted 
form  which  conceals  their  true  meaning.  The 
disguise  corresponds  to  what  is  left  of  the  repres- 
sion, and  in  general  the  more  extensive  its  fail- 
ure, the  less  complete  the  disguise. 

Depending  to  some  extent  on  the  degree  of 
failure  of  repression,  we  have  three  types  of 
neurosis:  (1)  hysteria  proper,  or  conversion  hys- 
teria, (2)  anxiety  hysteria  and  (3)  the  compulsion 
neurosis.  The  mechanism  or  structure  of  the 
symptoms  differs  with  each  type.  That  which 
returns  from  repression  (the  active  element  at 
least)  consists  of  instinctive  and  infantile  wishes 
and  strivings  which,  as  was  said,  are  out  of  ac- 
cord with  the  individual's  adult  and  ethical  self. 
Now,  in  what  we  may  call  a  wish-presentation 
there  may  be  distinguished  two  parts:  a  purely 
energic  element  called  by  Freud  the  **  affect- 
sum'*  (Affektbetrag)  whidi  I  have  already  men- 
tioned as  activation  energy,  and  an  ideational  ele- 
ment. Thus  when,  in  the  middle  of  the  day  I  find 
myself  desirous  of  eating,  I  am  able  to  divide 
this  presentation  into  its  energic  content  (the 
more  or  less  undifferentiated  urge  or  tension)  and 
its  ideational  content  (thoughts  of  lunch  instead 
of  thoughts  of  dinner,  ideas  of  some  particular 
kinds  of  food,  certain  anticipatory  images  of  eat- 
ing, thoughts  about  where  the  meal  is  to  be  ob- 
tained, etc.) 


CONVERSION  HYSTERIA  281 

v^  In  conversion  hysteria  the  ideational  elements 
remain  repressed  (unconscious)  while  the  energic 
element  (the  libido)  is  employed  in  somatic  in- 
nervatioUy  sensory  or  motor,  exciter  or  inhibitory, 
producing  a  purely  bodily  symptom  (a  pain, 
ansesthesia,  spasm,  paralysis  or  the  like).  The 
locus,  thus  over-innervated,  is  found,  on  analysis 
of  the  case,  to  bear  a  definite  relation  ^  to  the  na- 
ture and  content  of  the  wishes  thus  side-tracked 
and  in  some  way  represents  an  attempted  fulfill- 
ment of  them.  In  cases  where  the  conversion  is 
complete,  the  patient  shows  toward  the  symptoms 
the  typical  **  belle  indifference '*  of  hysteria. 
Some  of  the  activation  energy  may,  however,  es- 
cape somatic  conversion  and  lead  to  the  develop- 
ment of  affects  (anxiety,  depression,  etc.)  in  a 
varying  degree.  In  the  one  case  a  woman  tells 
uSy  for  instance,  that  she  has  a  perfectly  excru- 
ciating pain  in  her  abdomen,  yet  at  the  same  time 
she  is  perfectly  serene  and  smiling  and  seems 
totally  indifferent  to  her  "agony.'*  But  in  the 
other,  the  patient  is  worried.  She  asks  anxiously 
if  the  pain  may  be  due  to  a  cancer,  she  expresses 
a  fear  that  her  case  is  incurable,  and  she  begs  for 
some  medicine  to  bring  her  relief.  Since  in  cases 
of  complete  conversion  no  affects  are  developed, 
the  repression  or  defense  may  be  said  to  be  fairly 
successful  inasmuch  as  it  is  the  purpose  of  re- 
pression to  spare  the  individual  the  development 
of  painful  affects. 

In  anxiety  hysteria  and  the  compulsion  neurosis, 
on  the  other  hand,  the  repression  is  essentially  im- 

1  Freud:    "Sammlmig  Eleiiier  Schreften/'  VoL  II,  Chapter  I. 


282    MOBBID  FEABS  AND  COMPULSIONS 

sncoessful.  The  idea-content  of  the  repressed 
presentation  is  withheld  from  consdonsness  and 
remains  repressed.  Bnt  the  activation  energy 
(the  libido)  goes  fnlly  over  into  affect  develop- 
ment. In  the  former  neurosis  it  is  converted 
without  loss  into  an  equivalent  amount  of  fear. 
In  the  latter  there  is  again  no  loss,  affects  are 
developed  proportionate  to  the  amount  of  libido, 
which  may  take  the  form  of  fear  or  almost  any 
other,  usually  impleasant,  feeling  or  impulse. 
The  repressed  idea  is  replaced  in  the  individual's 
consciousness  in  each  case  by  a  substitute  idea. 
In  other  words  all  that  is  accomplished  by  the 
repression  is  an  avoidance  of  the  ideas.  By 
means  of  the  mechanism  of  displacement  the  en- 
ergies themselves  break  through  the  repression 
and  fully  manifest  themselves  in  consciousness. 

The  energy  displayed  in  the  compulsive  symp- 
tom (wish,  fear,  imperative  impulse,  prohibition, 
inhibition  or  what  not)  is  displaced  or  misplaced 
energy,  in  other  words  a  force  designed  for  some 
other  activities  than  that  in  which  we  fificL  it  ex- 
pressing itself.  The  symptoms  are  thus  substi- 
tute activities  and  take  the  place  of  some  other 
form  of  action  which  has  been  inhibited.  This 
will  perhaps  become  clearer  when  we  have  con- 
sidered the  examples  which  follow. 

I  shall  first  take  up  some  cases  in  which  the 
energic  element  of  the  wish-presentations  return- 
ing from  repression  entered  into  consciousness 
unchanged,  that  is,  still  in  the  form  of  a  wish. 
The  ^^ compulsion"  in  these  cases  depends  upon 
^e  fact  that  this  wish-energy  is  attached  in  con- 


SUBSTITUTE  ACTIVITIES  283 

sdonsness  to  some  new  idea-content,  is,  in  other 
words,  directed  to  a  substitnte,  rather  than  to 
what  is  actually  wished  for.  With  such  a  com- 
pulsion we  are  already  acquainted,  namely  that 
of  the  young  woman  who  had  a  morbid  impulse 
to  take  drugs.  A  similar  case  is  that  of  the 
woman  who  suffered  from  an  imperative  craving 
to  eat  bread.  When  a  little  girl,  she,  Jike  many 
other  children,  gained  the  impression  that  the 
fertilizing  substance  entered  the  body  by  way  of 
the  mouth,  that  pregnancy  was  brought  about  by 
the  mother's  swallowing  something — ^a  seed  or 
some  medicine.  Bread  is  very  familiarly  the 
"Staff  of  Life''  and  hence  could  be  a  symbol  of 
the  penis.  Her  compulsion  came  on  when,  after  a 
not  very  happy  wedded  life,  her  husband  died, 
leaving  her  childless.  The  unhappiness  of  her 
married  life  had  caused  the  patient  to  resolve  not 
to  make  a  second  venture.  But  her  natural  crav- 
ings for  sex  satisfaction  and  for  motherhood,  thus 
denied  their  natural  outlet,  were  displaced,  to  find 
expression  in  a  substitute  action.  The  symbolism 
of  the  substitute  action  was,  as  is  easily  seen,  com- 
pounded partly  from  infantile  and  partly  from 
adult  conceptions  of  the  initial  act  of  reproduc- 
tion. 

In  these  cases  it  is  to  be  seen  that  practically 
the  sole  effect  of  repression  was  to  push  the  wish- 
energy  or  libido  away  from  its  natural  ideational 
accompaniment  over  to  a  new  one,  thus  producing 
a  compulsive  wish  and  a  compulsive  action.  In 
another  type  of  compulsion,  repression  not  only 
separates  the  wish  from  its  original  ideational  ao- 


284    MOBBID  FEABS  AND  COMPULSIONS 

>,'  compaiiiment  but  also  produces  a  transformation 
of  the  wish  energy  into  anxiety.  We  have  then 
a  compulsive  fear.  Indeed  it  is  not  diffionlt  to 
imagine  such  a  thing  oocnrring  in  the  case  first 
mentioned,  that,  instead  of  a  desire  for  drugs 
and  an  impulse  to  take  them,  there  had  appeared 
a  fear  of  drugs,  or,  as  is  usually  the  case,  a  fear 
of  being  poisoned.  Such  fears  are  not  uncom* 
mon  and,  ordinarily,  have  precisely  the  same  sex- 
ual significance  as  in  the  case  we  have  mentioned. 
I  have  in  mind  a  very  similar  case  in  which  the 
patient,  a  young  unmarried  woman,  suffered  from 
a  fear  of  dust,  particularly  a  fear  that  she  might 
swallow  some  accidentally.  Thus,  as  soon  as  her 
food  was  cooked,  she  covered  it  with  a  carefully 
shaken  napkin,  which  remained  in  place  until  she 
was  ready  to  eat.  Before  she  could  bring  her- 
self to  eat,  she  would  carefully  brush  her  clothes, 
dust  the  table  doth,  and  repeatedly  wash  and 
rinse  her  dishes,  all  for  fear  that  some  particle  of 
dust  would  get  upon  her  food  and  she  would  un- 
knowingly ingest  it.  She  was  very  conscious  of 
the  absurdity  of  her  fear  and  often  argued  with 
herself  saying :  ^  ^  Why  should  I  be  afraid  f  Dust 
couldn't  hurt  me,  even  if  I  ate  a  lot  of  it.  It's 
perfectly  harmless;  in  fact,  according  to  the 
Bible  it's  what  we  are  made  of.  So  how  could  it 
do  me  any  harm!" 

But  these  thoughts,  though  not  interpreted  by 
the  patient,  disclose  the  meaning  of  the  compul- 
sion. Dust  being  ^^what  we  are  all  made  of" 
is  a  symbol  for  the  fertilizing  substance,  semen, 
and  thus,  to  an  unmarried  wopian,  at  least,  is  not 


SELF  BBPEOACH  285 

in  every  sense  harmless.  Her  fear  of  eating  dust 
is  similar  in  its  symbolism  to  the  other  cases  that 
have  been  mentioned  and  depends  upon  the  same 
infantile  theory  of  oral  impregnation. 

As  I  was  carefnl  to  emphasize  in  the  second 
chapter,  the  role  of  the  f oreconscions  is  not  a 
pnrely  passive  one,  or  limited  to  the  screening 
ont  of  elements  that  would  be  objectionable  to 
consciousness.  It  represents  rather  an  active, 
positive  force.  A  wish  remains  repressed  only 
through  the  continuous  activity  of  a  counter-wish. 
That  this  is  true  the  cases  thus  far  cited  do  not 
sufficiently  emphasize. 

By  virtue  of  the  fact  that  repression  is  active 
and  positive  we  often,  and  in  fact  ahnost  invari- 
ably, find  that  the  energy  or  driving  force  dis- 
played in  a  compulsion  is  not  derived  from  the 
repressed  force  alone  but  that  some  of  it  is  con- 
tributed  by  the  repressing  forces.  This  is  true 
to  an  even  greater  extent  in  the  compulsion 
neuroses  than  in  hysteria  or  anxiety  hysteria. 

This  fact  is  indicated  in  the  first  case  analyzed, 
as  I  may  now  mention,  for  the  young  woman  had 
herself  often  felt  that  the  desire  to  make  herself 
sick  was  to  some  extent  an  impulse  to  self -punish- 
ment, an  abortive  suicidal  attempt,  so  to  speak, 
which  was  designed  to  expiate  what  she  regarded 
as  sinful  in  her  thoughts  and  actions.  This  is 
very  typical.  A  compulsion  as  a  rule  is  a  result- 
ant of  two  sorts  of  forces,  the  one  represented  by 
the  repressed  wishes  which  are  breaking  through 
repression,  the  other  (of  a  character  directly  op- 
posite to  the  repressed)  has  its  origin  in  the 


286     MORBID  FEABS  AND  COMPULSIONS 

ethico-esthetic  part  of  the  self  and  corresponds 
to  the  repressing  forces.  The  following  is  a  good 
example. 

A  yonng  professional  man,  onmarriedi  began  to 
suffer  from  compnlsive  self-reproaches  which 
came  on  rather  suddenly  after  A  disappointment 
in  love.  The  reproaches  concerned  themselves 
with  most  trivial  matters,  as  a  rule,  sometimes 
one  thing,  sometimes  another,  yet  he  was  re- 
proaching himself  about  something  practically 
all  the  time,  and  in  a  seemingly  exaggerated  man- 
ner. Thus  one  day  he  went  into  a  store  to  buy 
a  straw  hat.  He  selected  one  that  suited  his 
fancy,  put  it  on  and  left  the  store.  Hardly  was 
he  outside  the  door  when  the  thought  came  upon 
him:  "You  ought  not  to  have  bought  that  hat.'* 
Absurd  as  it  may  seem,  the  sense  of  having  done 
wrong  which  he  experienced  was  of  very  great 
intensity.  He  continued  on  Ills  way,  arguing  with 
himself  to  the  effect  that  his  feeling  was  absurd, 
that  he  had  done  nothing  wrong,  yet  all  the  while 
the  sense  of  self-reproach  remained.  Finally  his 
distress  was  so  great  that  he  turned  and  began 
to  retrace  his  steps  toward  the  store,  intending 
to  exchange  the  hat  for  another  one.  On  the  way 
back  he  was  assailed  with  new  doubts,  for  he  kept 
thinking:  "Maybe  it  would  be  better  if  I  kept 
this  hat.  Maybe  I  am  making  a  mistake  if  I 
take  it  back."  By  the  time  he  had- reached  the 
store,  he  had  decided  that  it  would  be  better  to 
keep  the  hat,  so  he  started  for  home  again  with 
his  purchase  still  on  his  head.  Before  he  had  gone 
very  far,  the  first  sense  of  guilt  again  assailed 


SELF  BEPROACH  287 

him  and  finally  he  did  return  to  the  store  and^ 
when  exchanging  the  hat  for  another  one,  felt 
considerably,  if  not  entirely,  relieved.  He  went 
through  a  similar  performance  on  another  occa- 
sion when  he  had  gone  to  his  bank  to  get  a  new 
check  book.  No  sooner  had  he  received  the  book 
than  he  felt  he  ought  not  to  have  it,  that  he  must 
take  it  back,  that  he  was  doing  a  great  wrong  in 
delaying  an  instant  On  stiU  another  occasion, 
a  friend  suggested  to  him  that  he  ought  to  join 
a  certain  regiment.  Without  thinking  of  the  mat- 
ter at  all  seriously,  he  replied:  ^'Well,  perhaps 
I  will  join  before  long."  Soon  after  leaving  his 
friend  the  idea  suddenly  seized  him :  ^  ^  You  ought 
never  to  have  said  that.  You  shouldn't  join  the 
regiment,"  and  he  could  not  rest  until  he  had  got- 
ten into  communication  with  his  friend  and  taken 
back  his  words.  Having  done  so,  however,  he 
still  felt  dissatisfied,  and  kept  thinking:  ^^ Maybe 
it  would  be  better  if  I  did  join.  Maybe  I 
should  not  have  said  I  wouldn't,  etc."  A  day 
or  two  later,  having  berated  himself  continually 
in  the  meantime,  he  called  up  his  friend  and  told 
him  he  had  decided  to  join  after  all,  and  then  im- 
mediately the  first  set  of  reproaches  returned, 
so  that  still  later  he  had  to  retract  this  decision, 
etc 

This  patient,  let  it  be  understood,  was  a  man 
of  education  and  of  unusual  intelligence.  Yet 
against  these  absurd  doubts  and  fears  he  was 
absolutely  powerless.  And  though  continually 
beset  with  an  overwhelming  sense  of  doing  wrong, 
he  could  not  in  any  instance  point  out  what  there 


288     MORBID  PEARS  AND  COMPULSIONS 

was  wrong  in  the  things  he  had  done,  or  explain 
why  he  felt  guilty  and  reproached  himself.  I 
shonld  add  that  there  was  apparently  nothing  in 
his  life  that  should  give  oGcasion  for  such  feelings 
of  guilty  for  he  was  a  man  of  quite  exceptional 
morality,  and  commanded  the  liking  and  respect 
of  every  one. 

His  peculiar  symptoms  are,  however,  by  no 
means  inexplicable,  if  we  take  into  account  cer- 
tain elements  of  his  mental  life  that  were  not 
clearly  before  his  consciousness.  He  had,  as  was 
said,  been  disappointed  in  love.  The  situation 
and  circumstances  of  the  disappointment  were 
such  as  to  give  rise  to  a  considerable  degree  of 
resentment  on  his  part  toward  not  only  the  young 
lady  herself,  but  towards  his  family,  his  father 
in  particular.  His  hostility  to  his  father  was, 
however,  really  a  revival  of  earlier  hostilities 
dating  from  his  childhood,  which  related  to  in- 
terference and  punishment  but  which,  for  the  most 
part,  were  quite  fully  repressed  and  withheld 
from  his  consciousness. 

A  knowledge  of  the  existence  of  this  hostile  or 
sadistic  trend  is  sufficient  to  enable  us  to  explain 
the  symptoms  that  have  been  mentioned  without 
taking  up  its  origin  in  further  detail.  The  ex- 
planation of  his  compulsion  is  really  absurdly 
simple.  The  straw  hat  which  he  selected  in  the 
store  had,  at  the  back  of  the  sweat-band  inside  the 
crown,  a  tiny  bow  of  red  ribbon.  This  fact  he 
perceived  as  he  examined  the  hat,  without  its 
really  arresting  his  conscious  attention.  But  the 
important  thing  was  that  the  tiny  red  bow  looked, 


SELF  REPROACH  289 

as  he  glanced  at  it,  not  unlike  a  small  splotch  of 
blood.  Thus,  for  him  to  wear  that  hat  was,  in  a 
way,  to  have  blood  upon  his  head.  This  was  the 
reason  he  reproached  himself.  For  if  he  had 
put  into  action  the  hostile  impulses  he  was  re- 
pressing, he  would  in  fact  have  had  blood  upon 
his  head ;  he  would  have  murdered  some  one. 

The  incident  of  the  check  book  depends  upon 
a  similar  association  of  ideas.  The  one  he  first 
received  at  the  bank  had  a  bright  red  cover,  thus 
suggesting  blood,  and  to  keep  it  suggested  having 
^^ blood  upon  his  hands."  When  he  had  taken  it 
back  and  exchanged  it  for  a  yellow  one,  he  felt 
considerably  relieved. 

In  the  same  way  the  idea  of  joining  the  regi- 
ment had  become  connected  with  the  repressed 
murderous  trend,  for  there  had  passed  through 
his  mind  the  thought:  ^^ Suppose  I  join  the  regi- 
ment and  there  is  a  strike  or  a  riot,  for  which  the 
militia  are  called  out.^  Then  I  might  kill  some 
one.'* 

His  compulsive  vacillation  is  thus  seen  to  have 
had  its  origin  in  two  opposed  and  displaced  trends. 
The  one  which  led  him  to  reproach  himself  for 
having  purchased  the  hat,  received  the  check  book 
and  promised  to  join  the  regiment  was  derived 
from  his  conscious,  ethical,  social  and  affectionate 
self.  The  other  consisted  of  primitive,  savage, 
asocial  impulses,  inhibited  very  naturally  from 
direct  expression,  but  nevertheless  not  kept  en- 
tirely subdued  by  repression.  It  was  the  non- 
satisfaction  of  this  trend  which  led  him  to  criticize 

1  This  WM  before  the  beginning  of  the  European  War. 


290    MOEBID  PEAES  AND  COMPULSIONS 

hiB  desire  to  take  baok  the  hat  and  the  oheok 
booky  eta  and  was  responsible  for  his  laok  of 
oomplete  satisfaction  when  he  had  done  so. 
/  It  is  to  be  seen  that  in  this  case,  if  anything, 
more  energy  is  contributed  to  symptom  forma- 
tion by  the  repressing  forces  than  by  the  re* 
pressed.  His  compulsion  for  the  most  part  was  an 
overcompensation  on  the  part  of  his  conscious 
personality  for  his  unconscious  sadism.  It  was 
as  if,  vaguely  perceiving  his  subliminal  murder- 
ous tendencies,  he  could  not  be  content  merely  with 
avoiding  actual  murder  but  must  avoid  also  every^ 
thing  even  remotely  suggesting  it. 

We  may  now  take  advantage  of  this  case  to 
introduce  a  consideration  of  some  typical  features 
of  the  history  and  characteristics  of  compulsion 
neurotics.  This  young  man  was,  as  I  have  said, 
quite  exceptionally  moral  in  his  ordinary  behav- 
ior. He  was  a  most  dutiful  son,  devoted  to  his 
parents  in  a  very  marked  degree.  He  was  to  all 
appearances  good  tempered,  cpnscientious  to  a 
fault,  and  inclined  more  to  gentleness  and  sub- 
missiveness  than  to  aggression  and  pugnacity. 
But  these  traits,  be  it  remembered,  were  expres- 
sions of  his  consciotis  personality.^  The  history 
of  his  early  childhood  presents  quite  a  different 
picture.  For  as  a  very  small  boy  he  was  very  un- 
ruly,  jealous  and  subject  to  most  violent  fits  of 
anger  and  rage.  He  had  also  shown  at  times  a 
certain  tendency  to  be  cruel  to  other  children  and 

1  Hie  words  "conseioiiB  personality^  as  used  in  this  book  mean 
the  combined  tendencies  of  the  foreconscions  and  consdons 
(systems. 


BEPBESSED  SADISM  291 

to  animals.  His  brother,  of  whom  he  was  jealous 
at  times,  he  had  often  wished  dead,  and  on  one 
occasion  in  a  fit  of  anger  neairly  killed  him. 

Now  this  early  history,  or  the  equivalent  of  it, 
is  typical  of  the  compulsion  neurosis.  Careful 
study  invariably  shows  that  the  so-called  sadistic 
impulse  (the  tendency  to  aggression,  anger,  vio- 
lence and  cruelty,  a  trace  of  which  is  found  in  every 
person)  is  manifested  very  early  in  the  lives  of 
these  patients  and  in  a  very  vigorous  form.  But, 
and  partly,  no  doubt,  because  of  its  premature 
display,  the  impulse  early  gets  into  disrepute, 
for,  coming  into  conflict  with  the  corrective  dis- 
cipline on  the  part  of  the  parents,  often  not  very 
gently  administered,  it  succumbs  to  a  premature 
and  all  too  fundamental  repression.  This  repres- 
sion is  often  very  complete  by  the  fifth  or  sixth 
year  of  the  child's  life,  and  thereafter,  instead  of 
showing  the  sadistic  tendencies  which  earlier 
manifested  themselves,  he  is  more  apt  to  be  dis- 
tinguished by  an  exaggerated  over-conscientious- 
ness and  even  submissiveness,  particularly  to  par- 
ental authority.  What  happens  is  as  follows. 
The  repression  of  the  sadistic  impulse  produces 
not  its  annihilation  but  merely  its  transfer  from 
consciousness  to  the  Unconscious.  And  there, 
withheld  from  the  neutralizing  influence  of  con- 
scious reasoning,  this  impulse  and  the  phantasies 
derived  from  it  are  not  only  preserved  without 
deterioration  but  may  even  grow  in  vigor  and  in- 
tensity. Thus,  despite  the  fact  that  in  many  in- 
stances the  individual's  conscious  life  is  appar- 
ently singularly  irreproachable,  nevertheless  this 


292    MOBBID  PEABS  AND  COMPULSIONS 

life  is  £ved  ooincidently  with  an  tmderoEarrent  of 
impulses  of  anger,  hate,  hostility,  and  revenge  and 
their  corresponding  phantasies.  To  compensate 
for  this  snbstratnm  of  hostile  trends  the  consdons 
qualities  of  love,  sympathy,  considerateness  and 
scmpnlonsness  are  developed  often  to  an  unusual 
extent  and  participate  in  the  task  of  maiTttAJning 
the  repression. 

The  period  of  apparent  normality,  but  really  of 
successful  repression,  which  succeeds  upon  tiie 
earlier  phase  of  more  or  less  free  sadistic  activity 
is  terminated  with  the  outbreak  of  the  neurosis 
when,  the  repression  in  part  failing,  the  hostile 
tendencies  are  allowed  a  certain  limited  access 
to  consciousness,  subject,  however,  to  disguise  and 
distortion,  particularly  in  the  form  of  displace- 
ment. The  symptoms  produced  by  the  return 
from  repression  are  in  part  then  derived  from 
impulses,  in  the  shape  of  hate,  hostility,  etc,  com- 
ing from  the  Unconscious  and  in  part  from  the 
highly  developed  conscious  and  f  oreconscious  im- 
pulses of  love  and  conscientiousness  which  serve 
as  reaction  against  them. 

The  fact  that  the  hostile  responses  (or  rather 
the  impulses  so  to  respond)  are  for  the  most  part 
confined  to  the  Unconscious  produces  a  very  sm- 
gular  condition,  namely,  that  the  individual  is  able 
to  have  toward  the  same  persons  simultaneous  im- 
pulses of  both  love  and  hate,  both  possessing  a 
high  degree  of  intensity.  The  love,  no  matter  how 
great,  fails  to  neutralize  the  hate,  which  is  with- 
held from  it  in  the  Unconscious  and  merely  ac- 
complishes its  repression. 


/f 


ABOULIA  293 

The  first  effect  of  this  strange  constellation  of 
the  love-life  is  a  sort  of  ^^ weakness  of  will,"  an 
inability  to  make  decisions  in  matters  which  per- 
tain to  love.  For  the  nnconscions  hostility  pro- 
duces an  inhibition  or  resistance  in  carrying  out 
all  those  actions  for  which  love  would  be  the  im- 
pelling motive.  Thus  important  and  decisive  ac- 
tions are  put  off^  while  those  of  minor  importance 
are  carried  uncertainly,  irresolutely  and  without 
any  subjective  sense  of  full  satisfaction  and  final- 
ity. Evading  major  love  decisions,  the  patient 
very  typically  concentrates  his  energies  on  mat- 
ters preparatory  to  deciding,  but  here  too  the  ir- 
resolution and  lack  of  decisiveness  displays  itself 
and  the  patient  is  unable  to  achieve  anything 
final,  even  in  these  minor  matters.  The  abonlia, 
the  inability  to  decide,  thus  does  not  long  remain 
limited  to  the  original  love  problems  but  gradu- 
ally diffuses  itself  over  all  departments  of  the 
patient's  life. 

The  further  the  spread  of  irresolution  and  doubt 
is  carried,  the  greater  is  the  tendency  for  thinking 
to  take  the  place  of  action.  ^^The  native  hue  of 
resolution  is  sicklied  o'er  with  the  pale  cast  of 
thought'';  doing  is  replaced  by  doubting,  per- 
formance gives  way  to  pondering. 

The  compulsions  themselves  represent  an  ef- 
fort to  compensate  for  the  doubt  and  conflict  in 
the  love-life.  The  energy  dammed  up  through 
the  mutual  inhibition  of  the  opposed  impulses  of 
love  and  of  hate  is  continuously  seeking  an  outlet. 
Unable  to  discharge  into  the  actions  appropriate 
to  its  qualities,  it  forces  for  itself  new  avenues 


296    MORBID  FEAES  AND  COMPULSIONS 

hostile  movement  alternates  with  a  tender  one. 
They  are  a  manifestation  of  the  state  of  ambival- 
ence, the  coexistence  of  opposite  trends  of  love  and 
hate  toward  the  same  individnal.  Freud  gives 
the  following  example.^  His  patient,  a  young 
ofiBicer,  while  walking  along  a  street  struck  his 
foot  against  a  stone  lying  in  the  roadway.  The 
young  man's  fiancee  was  going  away  that  day,  and 
the  thought  came  to  him  that  on  her  way  to  the 
station  her  carriage  might  pass  along  this  street 
and  be  wrecked  on  this  stone,  and  she  come  to  in- 
jury. In  consequence  he  was  compelled  to  pick 
up  the  stone  and  carry  it  to  one  side  of  the  street. 
But  a  few  minutes  later  it  occurred  to  him  that 
what  he  had  done  was  very  foolish  and  absurd, 
whereupon  he  had  to  return  and  replace  the  stone 
in  its  original  position  in  the  middle  of  the  road- 
way. 

Gases  such  as  this  one  of  Freud's  or  my  case 
of  the  young  man  who  had  such  a  conflict  about 
his  straw  hat  show  a  type  of  symptom  formation 
that  is  usually  not  to  be  found  in  conversion  hys- 
teria or  anxiety  hysteria.  In  those  maladies  the 
rule  is  that  compromises  are  formed  which  sat- 
isfy opposite  trends  in  a  single  presentation ;  here, 
however,  the  opposite  impulses  are  discharged 
separately,  first  one  and  then  the  other,  of  course 
not  without  some  attempt  to  rationalize  into  some 
semblance  of  harmony  the  contradiction  between 
them.  The  patient's  removal  of  the  stone  from 
the  street  is  an  expression  of  the  overdeveloped 

1  "Bemerkiingen  fiber  einen  Fall  Zwangsneurofle/'  Jahrbach  f. 
peychoan.  u.  psychopath.  Forach.    Bd.  I.,  Hft.  2,  1009. 


AMBIVALENCE  297 

love  impulses;  but  his  action  in  returning  it  to 
its  original  position  did  not  come  from  a  purely 
objective  judgment  of  his  morbid  act  nor  signify 
a  healthy  erasing  of  it,  as  the  patient  might  have 
thought.  It  was  in  itself  a  compulsion,  a  part  of 
the  morbid  action,  and  motivated  by  an  opposite 
trend  from  that  of  the  first  part.  The  first  part 
expresses  the  thought:  **I  hope  no  injury  be- 
falls my  beloved";  but  the  second  does  not  mean, 
as  the  patient  probably  believed,  "I  must  not  be 
so  foolishly  anxious  about  her"  but  rather  "I 
hope  something  does  happen  to  her. ' ' 

The  state  of  ambivalence  which  distinguishes 
the  compulsion  neurotics  seems  to  arise  through 
a  constitutional  accentuation  of  the  sadistic  com- 
ponent of  the  holophilic  instinct.  The  undercur- 
rent of  hostility  which  in  these  patients  exists  in 
all  relationships  is  a  continuation  of  the  strong 
sadistic  trends  which  in  early  childhood  had  suc- 
cumbed to  a  premature  and  perhaps  too  extensive 
repression.  The  neurosis  itself  coincides  with  a 
fixation  in,  or  a  regression  to,  a  certain  stage  in 
the  evolution  of  the  holophilic  impulses  which 
precedes  the  final  genital  organization.  The 
holophilic  impulses,  as  I  said  in  the  first  chapter, 
are  more  or  less  independent  of  one  another  be- 
fore puberty.  Their  complete  synthesis  into  an 
harmoniously  operating  hierarchy  under  the 
primacy  of  the  genital  zone  does  not  occur  until 
the  beginning  of  sexual  maturity.  Nevertheless, 
preceding  this  final  synthesis,  there  are  states  of 
incomplete  organization  or  synthesis,  and  the  com- 
pulsion neurosis  results  from  a  regression  to  one 


298     MOEBID  FEARS  AND  COMPULSIONS 

of  these,  namely  the  so-called  sadistic-anal-erotic 
organization.  This  is  a  stage  in  which  the  in- 
dividual is  past  the  predominantly  autoerotio 
phase,  and  object-love  has  already  been  well  es- 
tablished ;  but  the  primacy  of  the  genital  zone  has 
not  yet  come  about.  A  division  of  the  holophilic 
impulses  into  antithetical  groups  which  rule  as 
'^masculine''  and  ^'feminine"  in  the  normal  adult 
sexual  life,  has  taken  place,  but  the  groups  at 
this  stage  cannot  be  so  distinguished,  and  are 
rather  to  be  called  ** active *'  and  ** passive.*'^ 
The  active  or  sadistic  group  coincides  with  the  in- 
stincts for  acquisition  and  mastery  and  its  main 
organic  complement  is  the  voluntary  muscular 
and  kinesthetic  systems  (as  the  genital  system  is 
the  prime  organic  complement  in  the  adult  organ- 
ization) while  for  the  passive  group  the  anal  zone 
is  the  chief  somatic  focus.  Each  group  has  its 
sexual  objects  which  are  not  necessarily  alike  or 
identical.  A  regression  of  the  libido  (after  a 
period  of  more  normal  distribution)  to  the  old 
channels  marked  out  by  the  pregenital  organiza- 
tion is  the  underlying  essential  factor  in  the  out- 
break of  a  compulsion  neurosis. 

A  somewhat  similar  return,  Freud  points  out,-  is 
at  times  to  be  observed  in  women  when,  having 
passed  the  menopause,  the  genital  function  is 
given  up.  They  become  on  the  one  hand  ill  tem- 
pered, quarrelsome,  tyrannical  and  malicious 
(sadistic  traits),  and  on  the  other  envious  and  ob- 

iThe  antitheflifl  "masculine-feminine''  as  diBtinguished  from 
"actiyepaB&iye"  does  not  exist  until  the  goiital  zones  become  the 
prime  foci  of  sexual  reference. 


»-- 


CUEIOSITY  IMPULSE  299 

stinate  (anal-erotic  traits)  though  daring  the 
period  of  sexual  functioning  they  had  shown  no 
tsuch  characteristics.^  Thus,  as  he  says,  such 
oharacteristicSy  corresponding  to  a  sadistic-anal- 
erotic  organization  of  the  impulses  may  not  only 
be  a  precursor  to  the  genital  phase  of  the  sexual 
life  but  likewise  its  aftermath.  But  whereas  the 
post-climacteric  regression  meets  with  no  par- 
ticular opposition  on  the  part  of  the  individual, 
it  is  resisted  in  the  case  of  compulsion  neurosis, 
is  confined  chiefly  to  the  Unconscious,  and  causes 
conflicts,  reaction  formations,  compromises,  com- 
pensations, etc.  The  character  of  the  compulsion 
neurotic  might  be  described  as  that  of  an  ill  tem- 
pered, willful  sadistic  child  or  of  a  querulous  hate- 
ful old  woman,  upon  which  has  been  superimposed 
a  corrective  stratum  of  such  qualities  as  senti- 
mentality, over-conscientiousness  and  over-moral- 
ity— ^which  the  tumultuou'S  undercurrents  continu- 
ally threaten  to  break  through.  The  compulsion 
neurosis  is  the  negative  of  the  sadistic  perversion. 
The  curiosity  impulse  which,  like  the  sadistic, 
has  one  of  its  roots  in  the  acquisitive  and  domina- 
tive  impulses  is  unusually  highly  developed  in 
cotnpulsion  neurotics  and  may  contribute  a  good 
deal  to  the  clinical  picture.  These  patients  as  a 
class  are  above  the  average  of  intelligence  and  are 
great  thinkers,  though  their  intellectual  activi- 

ft 

^Freod:  'IMe  Bispoflition  zur  Zwangsneurose,"  Int.  Zeltsehr. 
f.  Aerztliche  PBycboanalyse,  Vol.  I,  Ko.  6,  1013.  Cp.  Freud: 
''Charakter  imd  Anal-Erotik,"  Sammlung  kleiner  Schriften  xor 
Neuroaenlehre,  Bd.  II  or  Brill:  Anal-Eroiicigm  and  Character 
in  his  boolc  on  ^^PBychoanalyBia." 


300    MORBID  FEARS  AND  COMPULSIONS 

ties,  at  least  after  the  outbreak  of  the  neurosis, 
are  by  no  means  regularly  productive  of  any  tang- 
ible or  valuable  results.  But  a  good  deal  of  the 
libido  that  in  less  inhibited  persons  would  go  over 
into  action  is  in  these  cases  taken  over  by  chan- 
nels derived  from  the  curiosity  impulse  and  ex- 
pends itself  in  thought  **  Where  the  curiosity 
impulse  preponderates  in  the  constitution  of  the 
compulsion  patient,  morbid  pondering  will  be  the 
chief  symptom  of  the  neurosis.  The  reasoning 
process  itself  becomes  sexualized,  while  the  sex- 
ual pleasure,  which  was  already  connected  with 
the  content  of  thought,  now  becomes  diverted  to 
the  act  of  thinking,  and  the  satisfaction  of  accom- 
plishing an  intellectual  operation  becomes  felt  as 
sexual  satisfaction.  This  relation  of  the  curios- 
ity impulse  to  the  reasoning  process  makes  it  par- 
ticularly able,  in  the  different  forms  of  compulsion 
neurosis  in  which  it  plays  a  part,  to  tempt  toward 
reasoning,  where  there  is  offered  the  possibility 
of  pleasure  gratification,  the  energy  which  labored 
in  vain  to  express  itself  in  action.'*^  Freud  is 
of  the  opinion  that  there  occur  cases  of  compul- 
sion neurosis  which  have  as  their  basis  not  the 
sadistic  impulse  but  the  curiosity  impulse  alone. 
Compulsion  neurotics  have  a  certain  typical 
peculiarity  with  regard  to  superstition  and  the  pos- 
sibility of  the  death  of  other  persons.  Though 
a  great  proportion  are  very  materialistic  and  not 
religious,  nevertheless  they  are  almost  invari- 
ably   superstitious.    Their    superstitious    ideas 

^  Freud:  ''Bemerkongen  fiber  einen  Fall  Zwanganeoroae,*'  Jahr* 
bucb  ftLr  peychoan.  u.  pBychopath.  Forachungen^  Vol.  I^  1909. 


SUPEESTITION  301 

exist  along  side,  and  in  spite  of  their  mate- 
rialistio  convictions.  As  Frend  expresses  it, 
they  are  superstitions  and  at  the  same  time  not 
superstitions,  having,  as  it  were,  two  convictions 
on  the  matter,  rather  than  the  uncertainty  of  an 
unformed  opinion.  In  many  cases  their  super- 
stitions are  not  of  the  sort  current  among  the  un- 
educated, but  rather  private  ones  which  have  a 
common  origin  with  their  neurosis. 

The  thoughts  of  the  compulsion  neurotics  are 
continually  occupied  with  the  possibility  of  the 
death  of  others.  ''At  first  their  superstitious 
tendencies  had  no  other  content,  and  in  general 
perhaps  no  other  origin.  Above  all  things  they 
need  the  possibility  of  death  in  the  solution  of 
their  yet  unsolved  conflicts.  Their  essential  char- 
acteristic is  that  they  are  incapable  of  decision, 
particularly  in  love  matters.  They  endeavor  to 
postpone  each  decision  and,  in  doubt  as  to  what 
person  should  be  decided  for  or  against,  or  as  to 
what  rule  should  be  employed  in  making  the  de- 
cision, they  follow  the  model  of  the  old  German 
courts,  the  processes  of  which  were  commonly 
ended  by  the  death  of  one  of  the  contesting  par- 
ties before  any  judgment  was  handed  down.  So 
in  each  conflict  they  He  in  wait  for  the  death  of 
some  one  significant  to  them,  usually  a  loved  per- 
son, whether  it  be  one  of  the  parents,  or  a  rival 
or  one  of  the  love-objects  between  whom  their 
inclination  wavers.*'^ 

The  superstition  of  these  patients  is  related  to 
and  based  largely  on  a  belief  (unformulated  and 


302    MOBBID  FEABS  AND  COMPULSIONS 

in  the  main  nnoonscioiiB)  in  the  onmipotenoe  of 
their  wishes^  particularly  their  evil  wishes  against 
others,— the  so-called  Omnipotence  of  Thought. 
This  is  something,  however,  that  is  to  be  observed 
more  or  less  in  persons  with  other  types  of 
nenroses  and  in  many  normal  persons.  How  such 
a  belief  arises  has  been  ably  discussed  by 
Ferenczi  and  need  not  be  considered  here.^  It 
is  sufficient  for  our  purposes  merely  that  we  know 
it  exists. 

Inasmuch  as  in  the  preceding  chapters  we  have 
heard  so  much  about  the  highly  important  rdle 
of  the  Unconscious  in  the  neurosis,  while  in  the 
next  chapter  we  are  to  consider  a  case  in  which 
we  shall  find  that  a  leading  part  was  played  by 
factors  which  were  not  unconscious,  it  may  be 
well  for  me  to  say  that  in  the  compulsion  neurosis 
the  rule  is  that  the  recent  factors  in  the  patient's 
falling  sick  are  not  reduced  to  amnesia  by  the 
repression,  as  is  so  often  the  case  in  hysteria,  but 
are  dealt  with  by  a  different  defensive  technique. 
In  the  compulsive  cases  the  '^  infantile  precursors 
of  the  neurosis  may  sink  into  an  (often  incom- 
plete) anmesia.  On  the  other  hand  the  recent 
cause  of  the  illness  is  retained  in  memory.  The 
repression  has  here  employed  a  different  and 
really  more  simple  mechanism.  Instead  of  caus- 
ing the  trauma  to  be  forgotten,  it  has  withdrawn 
the  affect  belonging  to  it,  so  that  there  is  left  in 
consciousness  an  idea-content  which  is  deemed 
indifferent  and  non-essential.    The  difference  re- 

1  Ferenczi:    ''GontribuiloiUi  to  PflychoaiialyBis,''  Chapter  Vm, 
tr.  by  Ernest  Jonee. 


DISPLACED  EEPROACH  303 

sides  in  the  psychic  process  which  we  mast  infer 
as  being  back  of  the  phenomena.  The  result  is 
about  the  same  as  in  hysteria,  for  the  indifferent 
ideas  only  seldom  become  reproduced  and  play  no 
role  in  the  thought  activities  of  the  patient.  In 
differentiating  the  two  forms  of  repression  we  can 
utilize  the  assurance  of  the  patient  that  the  con- 
tent of  the  ideas  recovered  in  the  analysis  was 
in  the  one  case  always  known,  and  in  the  other 
had  been  forgotten  for  a  long  while." 

^^It  is  therefore  no  rare  occurrence  that  the 
compulsion  patients  who  suffer  from  self  re- 
proaches and  have  connected  these  affects  with 
false  causes,  make  the  correct  confession  to  the 
doctor  without  perceiving  that  it  is  from  what 
they  have  confessed  that  their  reproaches  are  de- 
rived.'' ^  And  when  it  is  explained  to  them  what 
the  relation  is,  they  still  fail  to  see  it,  saying: 
^^Oh,  that  doesn't  bother  me.  I  never  worried 
about  it." 

I  recall  a  striking  example  of  this  which,  though 
I  did  not  analyze  the  patient,  is  sufficiently  con- 
vincing. One  day  as  I  was  entering  the  rooms  be- 
longing to  the  neurological  department  at  Cor- 
nell Dispensary,  an  intelligent  looking  young 
woman  got  up  from  the  benches  belonging  to  the 
flkin  department^  which  is  next  door,  and  stopped 
me. 

^^Doctor,"  she  said,  ^'is  there  any  one  in  your 
department  who  knows  how  to  hypnotize  f" 

"Yes,"  I  replied,  **why  do  you  askf " 

"Because  I  want  to  stop  smoking  cigarettes. 


304    MORBID  FEABS  AND  COMPULSIONS 

and  I  can't  I  thought  maybe  if  I  oonld  be 
hypnotized  it  would  help  me.  I've  got  to  stop. 
The  things  are  killing  me." 

<<A11  right,"  I  8aid|  ^'oome  in  and  well  see 
what  can  be  done,"  and,  sitting  down,  I  began  to 
take  the  usual  routine  history. 

"Your  aget" 

"Twenty-five." 

"Occupation?" 

"I  am  a  prostitute." 

"What  diseases  have  you  hadf " 

"IVe  had  gonorrhea  and  syphilis.  I'm  being 
treated  for  syphilis  now  in  the  skin  department." 

"Do  you  drinkf " 

"Yes,  I  drink  quite  a  lot.  I  smoke  dope  and 
snuff  cocaine  a  little  too,  but  I  don't  think  I 
have  a  real  habit  for  them." 

"How  long  have  you  smoked  cigarettes? " 

"Five  years." 

"How  many  a  dayf "  (I  expected  her  to  say 
forty  or  fifty.) 

"Oh,  seven  or  eight." 

"But  that  isn't  very  many,"  I  said.  "I  don't 
believe  seven  or  eight  cigarettes  a  day  would  hurt 
you  at  all,  to  say  nothing  of  their  *Mlling'  you." 

"But  they  are  killing  me.  I  know.  I  feel  so 
nervous  and  worried  and  blue,  and  all  the  time 
I  am  always  thinking  I  am  going  to  die.  It's  the 
cigarettes  that's  doing  it.  I'll  be  dead  or  dippy, 
if  I  can't  stop  them  soon."  She  spoke  most  earn- 
estly and  seriously. 

"But  maybe  it  is  something  else — ^for  instance, 
the  kind  of  life  you  lead,  or  having  syphilis — ^that 


DISPLACED  EEPEOACH  305 

really  makes  yon  feel  bine  and  worried,  and  yon 
only  think  it's  the  cigarettes  that  are  doing  it.'' 

**No,"  she  said,  *'it's  the  cigarettes.  They're 
what's  killing  me.  I  know,  becanse  I  never  felt 
this  way  nntil  I  began  to  smoke  them." 

^^How  long  ago  did  yon  begin  the  sort  of  life 
you  are  now  leading?" 

**Five  years  ago.  I  was  a  perfectly  straight 
girl  np  to  then." 

^^Bnt  that's  jnst  the  time  yon  began  to  smoke 
cigarettes,  isn't  it f" 

**Ye8,  that's  right,"  she  admitted. 

**Bnt,"  I  asked,  **  since  yon  began  to  smoke 
cigarettes  and  to  do  these  other  things  at  jnst  the 
same  time,  how  do  yon  know  which  it  is  that  makes 
yon  feel  badly  f  Being  a  prostitnte  and  having 
gonorrhea  and  syphilis  might  mnch  more  easily 
cause  a  girl  to  feel  bine  and  worried  than  smok- 
ing a  few  cigarettes.  Don't  yon  think  it  possi- 
ble that  some  of  these  other  things  and  not  the 
smoking  are  the  real  reasons  why  yon  do  not  feel 
weUf" 

^^No,"  she  said,  ^'I  see  what  you  mean,  but  I 
don't  agree  with  yon.  Somebody  else  might 
worry  about  such  things,  bnt  I  never  do.  Old 
B.  E.  Morse  never  bothers  me.  If  I  conld  stop 
the  cigarettes^  I'd  feel  fine.  They're  what's  kill- 
ing me  and  nothing  else."  It  was  very  apparent 
that  she  really  believed  this,  and  that  no  ordinary 
argument  conld  shake  her  out  of  her  conviction 
— ^and  this  despite  the  fact  that  the  girl  was  by 
no  means  unintelligent. 

The  case  clearly  enough  was  one  in  which  the 


306     MORBID  PEARS  AND  COMPULSIONS 

patient  had  made  the  ^'correct  confession"^ 
without  realizing  that  what  she  had  confessed 
was  the  real  source  of  the  affects  that  were  trou- 
bling her.  Naturally  she  could  not  become  amnesic 
to  i}^e  fact  that  she  was  a  prostitute  and  a  suf- 
ferer from  venereal  disease.  She  was,  in  other 
words,  unable  to  defend  herself  against  these 
sources  of  painful  affects  by  completely  forget- 
ting theuL  The  next  best  defense  to  denying 
their  existence  (amnesia)  was  that  of  denying 
their  importance.  ^^  Somebody  else  might  worry 
about  these  things,  but  I  never  do."  This  the 
repression  could  accomplish,  whereupon  the  pain- 
ful affects,  which  as  depression,  nervousness,  etc, 
continued  practically  unaltered,  she  explained  to 
herself  as  the  result  of  something  relatively  in- 
nocent, namely  the  cigarette  habit. 

This  defensive  mechanism,  of  which  we  shall 
have  further  illustration  in  the  next  chapter,  re- 
minds one  of  the  following  familiar  story.  A 
sporty  young  man  who  was  not  feeling  '*fit,"  con- 
sulted a  physician.  **My  boy,"  said  the  doctor, 
when  he  had  made  his  examination,  ^^you  have 
been  going  too  fast  a  pace.  There  lies  your 
trouble.    Wine,  women  and  song  are  killing  you." 

**A11  right,  Doc,"  replied  the  young  man  cheer- 
fully; **I'll  cut  out  singing." 

This  story  serves  to  bring  out  an  important 
point  in  connection  with  defensive  displacement. 

1  Without  doubt  the  "oonfession**  web  inoomplete.  I  imagine 
that  oral  perversities  or  tendencies  thereto  constituted  one  of  the 
sources  of  the  displaced  affects,  and  that  this  was  one  of  the 
reasons  why  the  cigarette  habit  was  selected  as  a  substitute  idea, 
for  it  too  had  to  do  with  the  mouth. 


DISPLACED  EEPEOACH  307 

If  the  young  man  confined  his  reformative  efforts 
to  the  non-essential,  singing,  he  would  spare  him- 
self the  renunciation  of  those  other  activitieSi 
which,  being  more  pleasorable,  would  be  harder 
to  give  up.  Likewise  the  young  woman,  by  mak- 
ing, as  it  were,  a  scapegoat  of  her  cigarette  smok- 
ing, dodged  the  problem  of  so  reforming  the  rest 
of  her  life  that  there  would  be  no  cause  for  the 
development  of  guilt  affects.  She  had  thus,  in 
the  shape  of  whatever  sexual  satisfaction  or 
pecuniary  gain  she  derived  from  the  sort  of  life 
she  was  leading,  a  certain  ^'reward  of  illness," 
corresponding  to  the  ^^  secondary  function  of  the 
neurosis/*^  This  she  would  have  to  forego,  if 
(her  instincts  and  economic  situation  permitting) 
she  abandoned  such  a  life  in  favor  of  one  more  in 
accord  with  the  demands  of  her  conscience. 

1  Freud:  '^Allgemeineg  fiber  den  hysteriachen  Anf&Ue";  Samm- 
luag  kldner  Sduriften  nir  NeuroMnlelire,  Bd.  II. 


CHAPTER  Vn 

A  CASE  OF  COMPULSION  NEUBOSIB 
(tHB  case  OF  STELLA  J.) 

A  COMPLETE  report  of  an  analysis  would 
sometimes  be  as  long  as  the  stenographic 
report  of  a  hard  fought  legal  battle.  An 
absolutely  full  analysis  is  impracticable  as  it 
would  include  an  inventory  of  every  thought  and 
impulse  the  patient  had  ever  had  since  birth. 

The  fact  that  up  to  the  year  1917  there  were 
not  more  than  half  a  dozen  comparatively  com- 
plete reports  of  analyses  published  iu  any  lan- 
guage, (one  of  Freud's  was  an  unsuccessful  case 
and  the  other  a  full  analysis  but  incompletely 
communicated)  has  led  me  to  give  the  following 
case  in  as  great  detail  as  the  limits  of  this  book 
allow.  The  ordinary  objections  against  publish- 
ing such  material  are  less  weighty  in  the  present 
case  because  the  subject  is  a  clinic  patient  whose 
friends  are  not  likely  to  read  it,  and  the  circum- 
stances of  her  neurosis  were  known  only  to 
her  husband,  who  is  now  dead,  to  herself  and  to 
me. 

The  case  is  unsatisfactory  because  the  work 
was  interrupted  and  so  the  analysis  is  not  a  full 
one,  but  it  is  illuminating  because  of  the  documen- 
tary corroboration  of  the  facts  disclosed  by  the 
analysis  and  because  of  the  clearness  with  which 

308 


A  COMPULSION  NEUEOSIS         309 

it  shows  that  the  confessions  of  the  patient  were 
not  ^'suggested"  by  the  psychoanalyst.  It  con- 
firms the  correctness  of  some  of  Frond's  con- 
clusions as  to  the  mechanism  of  neurotic  disturb- 
anceSy  particularly  the  displacement  of  affects. 

The  case  is  also  valuable  in  the  light  it  throws 
on  some  points  in  psychoanalytic  technique,  show- 
ing as  it  does  (1)  the  gross  sexual  element  emerg- 
ing first,  (2)  a  non-sexual  but  exceedingly  import- 
ant factor  disclosed  later  but  with  great  resist- 
ance, (3)  the  insignificance  from  a  therapeutical 
point  of  view  of  an  apparent  willingness  to  get 
well  on  the  part  of  the  patient,  (4)  the  refutation 
of  the  charge  that  psychoanalysts  read  sex  into 
everything  and  (5)  the  confirmation  of  the  em- 
phasis which  psychoanalytic  theory  lays  on  sexual 
factors.  The  last  point  does  not  diminish  the 
value  of  the  present  analysis  as  an  illustration 
of  the  fact  that  other  elements  are  not  overlooked. 

'  PaBT  L      HiSTOBIOAZi 

(a)  Data  of  the  First  Visit 

In  May,  1911,  there  came  to  my  office  a  small, 
plump,  young  woman  who  bore  upon  her  round, 
good-natured-looking  countenance  an  expression 
of  distinct  anxiety. 

** Doctor,''  she  said  hurriedly,  **I  am  afraid  I 
am  going  insane.  I  once  went  to  a  fortune  teller 
and  I  imagine  he*  is  bewitching  me ;  do  you  think 
it  is  all  right  for  me  to  get  married  f" 

This  obsession  had  appeared  in  July,  1910,  ten 
months  earlier,  when  she  was  madly  infatuated 


310    MORBID  FEAES  AND  COMPULSIONS 

with  a  yonng  man,  and  upon  the  advice  of  her* 
cousin,  a  very  superstitious  girl,  had  sought  the 
services  of  a  fortune-telling  magician.  She  had 
the  idea  that  through  his  influence  the  young  man 
would  be  stimulated  to  ask  her  hand  in  marriage. 

Two  days  after  this  visit  she  was  suddenly 
seized  with  a  terrific  fear  that  the  fortune  teller 
was  exerting  some  spell  over  her  as  a  result  of 
which  she  would  die.  This  fear  of  death  was  suc- 
ceeded after  a  time  by  a  fear  of  insanity.  She 
soon  sought  treatment,  and  in  November  the  ob- 
session, which  had  continued  with  great  intensity 
up  to  that  time,  almost  completely  subsided,  only 
to  appear  again  the  following  March  (1911)  in 
all  its  original  intensity. 

I  was  surprised  to  learn  that  the  young  man, 
Max  by  name,  her  infatuation  for  whom  appeared 
f o  be  the  cause  for  her  getting  into  all  this  trouble, 
was  not  the  one  she  had  in  mind  when  she  asked 
me  about  marriage.  For  in  the  early  months  of 
her  illness.  Max,  serenely  unaffected  by  the  al- 
leged powers  of  the  man  of  magic,  had  passed  out 
of  the  young  lady's  life.  Another  young  man, 
whom  we  shall  call  Barney,  had  then  presented 
himself  and,  swayed  by  no  other  form  of  sorcery 
than  that  which  she  herself  exerted,  had  proposed 
to  her  and  had  finally  been  accepted. 

The  immediate  cause  of  her  great  anxiety  at 
the  time  she  came  to  me  seemed  to  be  that  the  day 
set  for  her  marriage  to  Barney  was  only  three 
weeks  off.  She  feared  the  fortune  teller  was 
making  her  insane  and  that  she  was  thus  destined 
to  bring  nothing  but  trouble  and  unhappiness 


A  COMPULSION  NEUROSIS         311 

npon  her  husband.  She  could  not  make  up  her 
mind  what  to  do,  for  despite  the  fact  that  the 
various  physicians  she  had  consulted  had  without 
hesitation  assured  her  that  there  was  not  the  least 
likelihood  of  her  ever  losing  her  mind,  she  was 
not  satisfied  and  could  not  banish  the  fear  that 
in  marrying  she  would  do  a  great  wrong  to  an 
iimocent  man. 

I  finally  said  that  although  I,  too,  was  convinced 
that  she  was  in  no  danger  of  becoming  insane,  I 
felt,  nevertheless,  that  it  would  be  well  for  her 
to  postpone  her  marriage  for  some  months  in  the 
hope  that  meanwhile  she  could  get  over  her  fears 
and  thus  take  without  any  undue  handicap  the  im- 
portant step  she  contemplated.^    But  this,  she 

iFhysidaiiB  are  often  conmilted  by  neurotic  patients  oonton- 
plating  matrimony  who  eacpress  some  more  or  less  vague  fear  that 
th^  may  be  impotent^  or  have  syphilis,  or  suffer  from  some  other 
111  which  would  render  marriage  inadvisable.  They  wish  to  be  ex- 
amined and  assured  that  their  fears  are  groimdless,  and  as  the 
physician  usually  does  not  find  any  evidence  of  the  condition 
which  the  patient  seems  to  fear,  the  assurance  desired  is  as  a 
rule  promptly  given.  Now,  as  this  case  shows,  one  should,  as  a 
matter  of  fact,  be  extremely  careful  in  such  cases.  The  patient's 
fear  that  some  condition  exists  which  would  prove  an  obstacle  to 
marriage  usually  means  either  a  vnsh  that'  such  were  the  case 
(showing  that  the  individual  in  question  is  really  of  two  minds 
in  regard  to  the  object  of  his  affections  and  that  to  a  certain 
degree  he  would  welcome  some  excuse  for  not  marrying)  or  that 
there  actually  is  some  reason  why  he  ou^t  not  to  marry,  although 
moi  the  one  he  fears.  Both  these  things  were  true  in  the  case  of 
this  young  woman.  But  although  in  some  cases  it  would  be  a 
serious  mistake  to  advise  the  patient  to  go  ahead  and  marry  in 
spite  of  his  fears,  yet  on  the  other  hand  there  are  cases  in  which 
to  advise  against  marriage  would  be  almost  equally  serious.  In 
short,  in  most  cases  of  this  sort  the  physician  has  no  way  of 
knowing  with  any  certainty  what  he  should  advise,  unless  he  ana- 
lyzes the  patient,  which  unfortunately  is  in  most  instances  imprac- 


312  MORBID  FEARS  AND  COMPXJLSIONS 

replied,  was  impossible.  AU  the  arrangements  for 
her  wedding  had  been  made,  the  invitations  had 
been  sent  out,  and,  finally,  neither  her  own  nor  her 
fiance's  parents  would  listen  to  any  proposal  of 
delay.  To  follow  my  advice  was  out  of  the  ques- 
tion. 

After  some  further  discussion  relating  to  the 
treatment  of  obsessions  and  to  the  probability  of 
her  recovery,  she  told  that  she  was  very  poor  and 
asked  if  it  would  not  be  possible  for  me  to  treat 
her  in  a  clinic.  On  this  account  I  referred  her  to 
Cornell  Dispensary. 

(6)  Results  of  the  First  Period  of  Treatment  and 
Detailed  History  Obtained  During  that  Time 

At  Cornell  the  young  woman  was  treated  for 
nearly  a  year  with  the  ordinary  medical  remedies 
employed  for  such  cases,  and,  in  addition,  with 
hypnotic  suggestion  administered  once  or  twice  a 
week  by  Dr.  Stechmann  or  myself.  Suggestion 
occasionally  gave  her  relief  which  lasted  for  a  few 
hours.  Bromides  and  other  drugs  seemed  to  have 
no  effect.  Cold  tonic  baths  received  at  another  in- 
stitution often  gave  her  temporary  relief.  On  the 
whole,  however,  she  had  not  made  the  slightest 
permanent  improvement  at  the  end  of  this  period 
of  treatment.  Her  fear  was  just  as  intense  and 
just  as  compelling  as  when  I  first  saw  her.  Her 
marriage,  which  took  place  at  the  appointed  time, 
seemed  to  have  no  particular  effect  upon  her  symp- 

ticable.  Gf.  Jones,  ''Der  StellungBnahme  des  Aerztes  zur  dea 
Aktual  Konflikten,"  Internationale  Zeitwhrift  fur  Aergtliche  Pty- 
ohoanalyw.  Vol.  HI,  1015. 


A  COMPULSION  :NETJE0SIS         313 

toms  other  than  to  cause  temporary  exacerbation 
of  her  fears  jnst  before  it. 

Dnring  this  first  period  of  the  young  woman's 
attendance  at  the  clinic,  although  I  made  no 
real  attempt  at  analysis,  I  talked  with  her  from 
time  to  time  and  endeavored  to  obtain  an  accu* 
rate  and  detailed^  history  of  her  neurosis 
and  the  events  which  attended  its  develop- 
ment. When,  then,  late  in  the  spring  of  1912  I 
decided  to  begin  an  analysis,  I  had  at  my  com- 
mand the  following  items  of  history.  The  pa- 
tient, whom  we  may  call  Stella,  was  then  twenty- 
three  years  old.  Her  family  history  was  decid- 
edly psychopathic.  Her  mother,  two  brothers, 
and  her  sister  had  at  different  times  suffered  from 
various  forms  of  psychoneurosis. 

The  clinical  past  history  which  she  gave  con- 
tained nothing  of  particular  interest.  She  had 
had  the  usual  diseases  of  childhood,  and  had  been 
inclined  to  be  nervous  as  long  as  she  could  remem- 
ber. Her  menstruation  had  often  been  irregular 
and  scanty.  Sometimes  weeks  elapsed  between 
her  periods,  and  on  a  few  occasions  the  interval 
had  been  as  long  as  several  months. 

When  thirteen  and  a  half  years  old  she  had  suf- 
fered, she  stated,  from  some  sort  of  nervous  illness 
which  lasted  about  two  years.  It  was  brought  on, 
she  believed,  by  the  sudden  death  of  an  aunt  about 
four  years  older  of  whom  she  had  been  extremely 
fond.  The  symptoms  of  this  nervous  illness  she 
could  not  describe  definitely,  but  she  remembered 
that  she  lost  weight,  was  very  much  depressed,  and 
dreamed  of  her  aunt  nearly  every  night.    One  of 


314    MOBBID  FEARS  AND  COMPULSIONS 

the  doctors  who  attended  her  made  the  statement 
that  she  was  "very  poor  in  blood."  She  could 
not  remember  what  her  aunt  died  of,  bnt  thought 
"it  was  from  worrying  about  something.'' 

Physical  examination  was  practically  negative. 
The  patient  was  well  nourishedi  rather  fat  in  fact ; 
examination  of  the  heart  and  lungs  and  nervous 
system  failed  to  reveal  anything  significant  She 
had  a  moderate  anaemia;  the  urine  was  negative. 

Stella  was  bom  in  a  small  village  in  Bussia. 
Her  parents  were  Hebrews,  religious  to  the  point 
of  fanaticism  and  full  of  all  sorts  of  Old-World 
fables  and  superstitious  beliefs. 

Stella's  father,  a  Talmudic  school  teacher  in  his 
old  home,  had  come  to  this  country  when  she  was 
five  years  old,  but  his  family,  which  already  in- 
cluded two  boys  both  younger  than  Stella,  did  not 
join  him  until  four  years  later. 

In  the  New  World  little  prosperity  awaited 
them.  The  father,  a  man  whose  reputation  for 
piety,  honesty,  and  religious  scholarship  gave  him 
no  little  standing  in  synagogic  circles,  did  not 
shine  in  the  world  of  business;  and,  although  he 
managed  to  keep  his  family  from  falling  into  ac- 
tual want,  he  was  never  able  to  provide  any  other 
home  for  them  than  a  cheap  flat  in  a  lower  East 
Side  tenement. 

When  Stella  was  sixteen  the  f  amUy,  by  that  time 
augmented  by  the  arrival  at  different  intervals  of 
three  more  boys  and  one  girl,  threatened  to  become 
an  economic  problem  so  far  beyond  her  father's 
power  of  solving  that  she  sought  employment  in 
order  to  lighten  his  burdens.    She  soon  obtained  a 


A  COMPULSION  NEUBOSIS         315 

place  in  a  department  store  where  she  worked  np 
to  the  year  she  was  married. 

Stella's  education,  began  in  Enrope  along  the 
most  old-fashioned  orthodox  Jewish  lines,  was 
continued  in  this  country  in  the  public  schools. 
From  the  beginning  she  not  only  displayed  a  great 
fondness  for  study,  but  also  gave  every  evidence 
of  possessing  more  than  average  intelligence. 
Throughout  her  school  days  she  worked  hard  and 
almost  invariably  led  all  her  classes.  Her  educa- 
tion was  not  extensive,  however,  for  at  thirteen 
and  a  half  she  had  to  stop  school  ^^  because  her 
mother  needed  her  help  with  the  housework." 

Her  religious  ideas  were  in  her  early  years  a 
replica  of  those  of  her  parents.  She  prayed  and 
worshiped  in  the  most  orthodox  manner,  and, 
in  addition,  accepted  without  question  the  beliefs 
in  magic,  witches,  the  evil  eye,  and  similar  super- 
stitions which  prevailed  in  the  town  of  her  birth. 
After  passing  her  fifteenth  year,  however,  she 
went  rapidly  to  the  opposite  extreme  and,  soon 
abandoning  both  religion  and  superstition,  pro- 
fessed herself  to  be  an  absolute  atheist  and  ma- 
terialist. 

Her  infatuation  for  Max  was  her  first  love  affair 
of  any  importance.  She  had  always  been  popular 
with  the  young  men,  and  she  liked  them,  but  at  no 
other  time  had  her  affections  become  seriously 
involved. 

Stella's  affair  with  Max,  her  visit  to  the  fortune 
teller,  and  the  immediate  sequelsB  of  this  visit  are 
of  so  much  importance  that  I  must  take  up  the  his- 
tory of  these  matters  in  considerable  detail. 


316    MOEBID  FEABS  AND  COMPULSIONS 

In  the  early  stuniner  of  1910  Stella  went  to  a 
country  boarding  house  for  her  vacation.  There 
8he  first  heard  of  Max.  He  had  been  at  the  place 
the  previous  summer  and  made  himself  a  general 
favorite.  All  spoke  with  enthusiasm  of  his  intel- 
ligence, his  refinement,  and  his  good  looks.  He 
was  to  arrive  shortly,  and  on  the  day  he  was  ex- 
pected, Stella,  whose  curiosity  had  been  awakened 
by  the  praise  she  had  heard  of  him,  went  to  the 
railroad  station  in  order  to  get  an  early  glimpse  of 
the  paragon.  Catching  sight  of  him  just  as  he 
stepped  from  the  train,  she  felt,  from  that  very  in- 
stant,  that  she  loved  him.  Immediately  and  with 
a  sense  of  deepest  conviction  she  said  to  herself, 
**Here  is  the  man  I  must  marry." 

He  was  introduced,  and  appeared  to  like  her  at 
once.  Soon,  to  her  joy,  it  became  evident  that  he 
preferred  her  society  to  that  of  any  of  the  other 
girls,  and  in  a  short  time  her  love  became  an  all- 
consuming  madness  such  as  she  had  previously 
never  dreamed  of.  She  was  in  the  most  tensely 
excited  emotional  condition  imaginable.  She 
could  neither  eat  nor  sleep.  At  night,  or  whenever 
she  was  alone,  she  cried  continually.  She  lost 
weight  rapidly  and  to  such  a  degree  that  her 
friends  began  to  comment  upon  her  appearance. 

Max,  though  by  no  means  in  a  condition  of  equal 
distraction,  was  to  all  appearances  in  love.  From 
morning  to  night  he  was  in  her  company,  paid  her 
every  attention,  and  showed  the  utmost  jealousy 
of  every  look  or  word  she  bestowed  upon  possible 
rivals.  All  the  guests  at  the  boarding  house  were 
sure  that  a  proposal  was  imminent.    Nevertheless 


A  COMPULSION  NEUEOSIS         317 

it  did  not  come.  On  the  contrary,  Max  maintained 
a  most  loflezible  reserve.  Not  the  slightest  hint 
of  love  passed  his  lips ;  never  did  he  attempt  even 
the  most  fleeting  and  noncommittal  of  caresses. 

When  their  vacations  ended  and  they  both  re- 
turned to  the  city,  Max  called  on  Stella  frequently, 
took  her  to  various  places  of  amusement,  and,  as 
far  as  his  acts  were  concerned,  gave  every  evi- 
dence of  love  and  devotion.  But,  in  what  he  said, 
he  was  as  reserved  as  ever.  On  no  occasion  did 
he  let  fall  a  single  word  that  could  be  construed  to 
mean  anything  more  than  that  his  feeling  for 
Stella  was  the  most  ordinary  unromantic  sort  of 
friendship. 

This  paradoxical  attitude  on  the  part  of  Max 
struck  me  as  being  so  singular  that  I  at  once  asked 
Stella  if  she  knew  the  reason  for  it.  '^Yes,''  she 
replied,  ''Max  was  not  a  marrying  man.  I  know 
that  because  he  said  so  to  a  friend  of  mine,  who 
told  me  all  about  it.  But  he  assured  my  friend 
that  if  he  were  to  marry  anybody  he  certainly 
would  marry  me,  and  I  know  that  is  so. " 

When  I  asked  why  Max  was  not  a  marrying 
man,  Stella  explained  that  he  was  very  ambitious, 
but  had  only  a  small  salary,  and,  as  he  felt  that  an 
early  marriage  would  seriously  handicap  him  in 
business,  he  had  decided  to  forego  that  pleasure. 
But  this  explanation,  though  seemingly  plausible 
enough,  left  me  with  the  vague  suspicion  that  per- 
haps Stella  was  not  telling  all  she  knew. 

Stella's  disastrous  visit  to  the  fortune  teller 
occurred  in  August  of  the  same  year  she  met  Max. 
She  had  continued  in  a  state  of  mad  infatuation  all 


I 


318    MOBBID  FEABS  AND  COMPULSIONS 

sunmiery  and,  when  she  confided  her  condition  to 
her  consin  Boee,  the  latter  immediately  suggested 
magic  as  a  way  of  inducing  in  Max  a  like  state  of 
mind,  and  ultimately  bringing  about  a  wedding. 
Bosoy  who  was  superstitious  and  credulous  to  the 
highest  degree,  supported  her  recommendation 
by  relating  a  great  number  of  instances  of  maid- 
ens (with  whom,  she  said,  she  was  personally  ac- 
quainted) who  had  resorted  to  such  methods  with 
most  remarkable  and  gratifying  results.  But 
Stella  scoffed  at  these  stories,  as  she  did  at  all  the 
rest  of  the  wonder  tales  Bose  was  continually  tell- 
ing, and  at  first  refused  to  have  anything  to  do 
with  magic  and  fortune  teUers. 

Some  days  later,  however,  when  Stella  had  ac- 
companied Bose,  who  had  some  eye  trouble,  to 
what  we  will  call  St  Christopher's  Clinic,  she  said 
suddenly  as  they  were  walking  home,  ''Bose,  I 
think  I  would  like  to  go  to  a  fortune  teller  after 
aU/' 

This  suggestion  Bose  received  with  much  en- 
thusiasm, and,  informing  Stella  that  she  had  only 
recently  heard  of  a  man  reputed  to  possess  truly 
extraordinary  powers,  she  proceeded  to  conduct 
her  to  him  without  delay. 

The  fortune  teller,  magician,  or  Mahoshef,  as 
they  called  him,  proved  to  be  a  fat,  dirty,  and 
ignorant  Austrian  Jew  who  inhabited  a  greasy 
tenement  in  the  neighborhood  of  Canal  Street. 
Bose  was  ushered  into  his  presence  first,  while 
Stella  waited  in  a  room  outside  where  the  Maho- 
shef  's  wife  entertained  her  with  tales  of  his  prow- 


A  COMPULSION  NETJEOSIS         319 

Soon  Bose  retained  in  great  excitement  ' '  Ete  's 
a  wonder,  Stella!''  she  cried.  ''He  knows  every- 
thing! He  knew  what  your  trouble  was  the  min- 
ute you  came  in.  He  said  right  away  that^ou 
were  very  nervous  over  a  love  affair.  What  do 
you  think  of  that!'' 

Stella  replied  to  this  somewhat  sarcastically, 
but  she  arose  and  went  into  the  Mahoshef 's  room. 
She  was  already  a  little  afraid  of  him.  In  spite  of 
the  fact  that  his  wife's  recital  of  his  achievements 
had  excited  her  profound  contempt,  and  that  the 
man's  appearance  and  behavior,  once  she  was  in 
his  presence,  served  to  increase  this  feeling,  she 
had,  nevertheless,  a  vague  fear  of  him  all  through 
the  visit. 

The  first  thing  he  did  was  to  offer  to  tell  her, 
without  asking  any  questions,  her  own  name  and 
the  name  of  her  sweetheart,  and  though  he  suc- 
ceeded in  doing  so  by  means  of  a  somewhat  clumsy 
trick,  Stella  immediately  saw  through  it  and 
jeered  at  him  for  his  pains.  But  the  Mahoshef, 
not  in  the  least  discouraged,  wormed  out  of  her  the 
story  of  her  affair  with  Max,  and  promptly  as- 
sured her  that  by  means  of  certain  powers  of 
which  he  was  master  be  could  not  only  obtain  Max 
for  her  as  a  husband,  but,  if  she  preferred,  any 
other  man  she  would  name,  regardless  of  what  his 
race,  creed,  color,  or  social  position  might  be.  As 
evidence  of  his  ability  in  this  line  he  showed  her 
a  book  wherein,  so  he  said,  were  written  the  names 
of  many  of  the  most  prominent  and  wealthy  women 
of  the  city,  for  all  of  whom  he  assured  her  he  had 
performed  similar  services. 


320    MOEBID  FEAES  AND  COMPXJLSIONS 

**I  can  do  everything  I'*  he  cried  boastfully. 
"For  me  all  kinds  of  Kishef  (magic)  are  easyl" 

It  was  just  about  this  point,  however,  that  in 
spite  of  her  contempt,  in  spite  of  her  full  apprecia- 
tion of  the  grotesque  incongruity  between  what 
the  man  professed  to  be  and  what  his  manner  of 
living  indicated,  Stella  began  to  believe  him.  She 
therefore  directed  him  to  proceed  with  his  Kishef 
and  bring  Max  to  her  feet  at  the  earliest  possible 
moment,  while  she  permitted  him  to  collect  in  ad- 
vance the  fee  of  fifty  cents  which  he  demanded 
for  this  important  service.  Her  belief  in  him 
was  so  strong  that  when  she  left  him — after  he 
had  urged  her  to  buy  an  infallible  cure  he  had  in- 
vented for  rheumatism  and  she  had  politely  de- 
clined on  the  grounds  that  she  was  not  at  the  time 
afflicted  with  that  malady — she  returned  home  in 
the  most  cheerful  state  of  mind  she  had  experi- 
enced in  some  months. 

"I*m  so  happy,"  she  said  to  Rose ;  "now  I  know 
I  can  marry  Max.''   ^ 

There  followed  two  days  of  joyful  expectation. 
Stella  and  Bose  talked  continually  of  magic  and 
witches,  and  of  the  pleasing  results  they  expected 
from  their  venture.  And  all  the  while  Stella's 
faith  in  the  Mahoshef  seemed  unshaken ;  yet,  para- 
doxically enough,  her  skepticism  appeared  to  be 
almost  as  strong  as  ever.  "It  was  all  Rose's 
fault/'  Stella  complained  to  me  afterward; 
"she  talked  so  much  superstition  into  me  that 
finally  I  got  to  believe  it,  although  I  really  knew 
better." 

On  the  evening  of  the  second  day  after  their 


A  COMPULSION  NETJEOSIS         321 

vifiit  to  the  magician  the  two  girls  were  lying  in 
bed  discussing  the  usual  theme.  Stella  again  said, 
**I'm  so  happy— now  I  can  marry  Max" ;  but  after 
a  pause  she  continued,  '^I'm  sorry,  ijiough,  to 
have  to  get  him  in  this  way.  I  don't  like  this 
magic  business — ^I'd  rather  get  him  in  the  right 
way.  I  wonder  what  he  'd  think  if  he  knew.  I  'm 
afraid  I'm  going  to  worry— I  think  that  after  we 
are  married  I'll  tell  him  all  about  it — ^I'll  worry 
myself  sick  if  I  don't" 

"You're  a  fool,"  returned  Bose.  *'Why  should 
yon  worry  about  how  yon  get  him  as  long  as  you  do 
get  him?  You're  too  honest  I  You  make  me 
sickl" 

This  matter  was  soon  dropped  and  Bose  went 
on  to  teU  the  story  of  a  young  woman  who  had 
caused  a  man  to  fall  violently  in  love  by  secretly 
putting  some  menstrual  blood  in  his  tea.  "It 
worked  wonderfully,"  concluded  Bose.  "The 
man  was  crazy  about  her,  but  all  the  rest  of  his 
life  he  was  never  very  well. "  "  Oh,  by  the  way, ' ' 
she  went  on,  "did  you  know,  Stella,  that  if  Max 
has  magic  done  to  him  he'll  be  weak  and  sickly  all 
the  rest  of  his  life?  He  can't  live  to  be  older  than 
fifty  at  the  very  most,  and  maybe  not  even  that 
long." 

Immediately  upon  hearing  these  words  Stella 
was  seized  with  terrible  fear.  "Ohl"  she  cried, 
"isn't  that  awfull  I  cant  have  a  man's  days 
shortened  for  my  pleasure  I  I  can 't  have  him  lose 
his  life  on  my  account. ' ' 

"You  are  so  stupid,"  replied  Bose  in  great  con- 
tempt ;  ^  ^  why  should  you  care  ?    I  wouldn  't  let  the 


322     MORBID  FEABS'  AND  COMPULSIONS 

lives  of  fifty  men  stand  in  the  way  of  my  happi- 
ness." 

But  this  lofty  sentiment  had  no  effect  upon 
Stella.  Almost  the  very  instant  she  heard  the 
wordSi  **it  Max  has  magic  done  to  him  hell  be 
weak  and  sickly  all  the  rest  of  his  life/'  the  ter- 
rific fear  had  come  upon  her  that  the  Mahoshef 
was  exerting  magic  npon  her  and  that  she  was 
going  to  die.  All  the  rest  of  the  night  she  spent 
crying  and  screaming  in  constant  terror. 

Early  the  next  morning  she  went  back  to  the 
Mahoshef,  told  bim  she  did  not  want  the  yomig 
man  after  all,  and  begged  him  to  stop  the  Kishef 
at  once.  He  immediately  and  repeatedly  assured 
her  that  she  had  nothing  to  fear,  but  this  did  not 
help  her,  and,  returning  home,  she  told  her  family 
that  she  was  going  to  die,  ordered  her  clothes  to 
be  given  away,  and  indicated  where  she  wished  to 
be  buried. 

On  the  following  day,  although  she  was  as  much 
alive  as  ever,  her  fear  was  unabated,  and  she  re- 
turned to  the  fortune  teller  to  renew  her  entreaties, 
but,  as  before,  without  relief.  For  several  days 
she  continued  to  visit  him,  but,  fiinally,  as  his  as- 
surances brought  her  not  the  slightest  comfort, 
she  told  him  she  was  going  to  see  a  doctor.  He 
was  evidently  alarmed  by  this,  and  threateningly 
forbade  her  to  do  anything  of  the  kind. 

Eventually  of  her  own  accord,  she  went  to  the 
Broadway  Clinic.  There  one  of  the  dinio  physi- 
cians became  much  interested  in  her  case,  and,  as 
I  have  said,  she  finally  improved  under  the  hyp- 
notic suggestion  which  he  administered.    But  be- 


A  COMPULSION  NEUROSIS         323 

fore  this  improvement  took  place  she  spent  five 
days  as  a  voluntary  patient  in  a  hospital  for  the 
insane  and  a  week  or  so  in  a  neurological  hospital 

With  the  onset  of  her  obsession,  her  attitude  to- 
ward Max  underwent  a  peculiar  modification.  Up 
to  that  time,  although  apparently  she  was  madly 
in  love  with  him,  she  had  maintained  the  most  per- 
fect maidenly  reserve.  As  soon  as  the  obsession 
came  on,  however,  her  love  for  him  seemed  to  di- 
minish, but,  singularly  enough,  her  reserve  dimin- 
ished also.  Though  she  had  invariably  been  any- 
thing but  forward  in  her  relations  with  men  up  to 
that  time,  she  now  b^an  to  pursue  Max  in  a  most 
vigorous  and  aggressive  manner.  She  continually 
pressed  him  to  come  to  see  her,  hinted  most 
broadly  at  the  state  of  her  affections,  and  used 
every  means  at  her  command  to  bring  him  to  the 
point  of  proposing.  But  in  spite  of  all  her  efforts 
he  remained  as  noncommittal  as  ever — ^indeed,  if 
anything,  he  became  more  reserved. 

At  last,  driven  to  desperation  by  this  Fabius 
of  the  affections,  she  adopted  tactics  which  not 
only  forced  the  issue,  but,  from  the  point  of  view  of 
decisiveness,  left  nothing  to  be  desired.  Thus,  one 
day  in  November,  when  Max  was  calling  upon  her, 
she  said  to  him,  '^If  a  yoimg  man  loves  a  young 
lady,  and  wants  to  marry  her,  he  should  say  so. 
Otherwise,  she  might  learn  to  love  some  one  else.'' 

Max,  doubtless  feeling  unable  to  attack  this  ob- 
viously unimpeachable  precept,  replied,  ^^If  a 
young  man  were  in  love  with  a  young  lady,  and 
felt  that  he  was  in  a  position  to  marry,  he  wovld 
say  so.'' 


324    MOBBID  FEABS  AND  COMPULSIONS 

And  to  this  highly  abstract  proposition,  which 
Stella  apparently  found  to  be  quite  as  nnassail^ 
able  as  her  own,  she  made  no  reply. 

Max  then  changed  the  subject,  and,  after  dis- 
coursing for  a  short  time  upon  the  weather  and 
other  matters  of  equally  profound  public  and  pri- 
vate interest,  politely  wished  her  good  evening 
and  withdrew.  Except  for  one  occasion,  when  she 
happened  to  meet  bim  on  the  street,  she  has  never 
seen  him  since. 

It  was  shortly  after  Max's  final  visit  that  she 
began  to  improve.  From  the  time  her  obsession 
began  she  had  been  so  sick  that  work  was  out  of 
the  question,  but  now  she  felt  so  mudi  better  that 
she  became  anxious  to  earn  money  again,  and,  in 
December,  she  went  back  to  her  old  place  in  the 
store. 

Her  acquaintance  with  Barney  began  in  Novem- 
ber, soon  after  her  friendship  with  Max  ended. 
Previous  to  this  time  Barney  had  been  living  in 
another  city  and  Stella  had  never  seen  him.  How- 
ever, she  had  heard  of  him  frequently  through  his 
sister,  Esther,  who  was  one  of  her  closest  friends. 
Barney  appeared  to  like  Stella  from  the  first,  and, 
as  time  went  on,  his  feeling  rapidly  became 
warmer,  so  that  by  the  end  of  three  or  four  months 
they  reached  a  secret  understanding  and  still  later 
announced  themselves  as  engaged. 

For  a  while  things  went  fairly  well  with  Stella 
after  she  returned  to  work.  Her  fear  of  the  for- 
tune teller  had  almost  disappeared,  and  she  seemed 
to  be  in  very  good  spirits.    Then,  in  March,  the 


A  COMPULSION  NEUBOSIS         325 

fear  suddenly  returned  and  she  was  as  sick  as 
ever. 

The  revival  of  the  obsession  occurred  under  the 
following  drcumstances.  Just  before  Saint  Pat- 
rick's Day  Stella  heard  some  of  the  girls  in  the 
store  talking  of  the  coming  celebration  and  asked 
one  of  them  what  it  was  that  gave  the  Saint  his 
particular  claim  to  distinction.  '^Oh,  don't  you 
know  that  ? ' '  returned  the  girl.  *  *  Why,  he  was  the 
one  who  drove  the  snakes  out  of  Ireland." 

Stella  became  fearful  immediately.  ^^Oh,  that 
must  have  been  magic ! ' '  she  said  to  herself.  ^ '  I  'm 
afraid— if  that  could  happen,  n:iaybe  the  Mahoshef 
can  do  n:iagic  to  me ! " 

All  the  rest  of  the  day  she  felt  anxious  and  un- 
easy and  kept  thinking  about  magic  and  witches. 
The  next  morning  when  she  awoke  the  old  fear 
was  upon  her,  in  all  its  original  fury. 

She  went  to  work,  however,  but  in  the  store  she 
was  so  overwhelmed  by  fear  that  she  lost  all  con- 
trol of  herself,  fell  to  the  floor  crying  and  scream- 
ing, and  had  to  be  taken  home  in  a  taxicab. 

As  soon  as  she  was  able  to  do  so,  she  again  went 
to  the  Broadway  Clinic,  but  the  treatment  she  re- 
ceived there  helped  her  no  longer.  The  fact  of 
her  approaching  marriage  added  to  her  perplex- 
ities, and  she  felt  her  condition  to  be  most  des- 
perate. Finally,  she  took  some  of  the  money  she 
had  saved  for  her  wedding  finery  and  went  to  see 
Dr.  Dana,  hoping  that  he  could  either  convince  her 
that  she  had  nothing  to  fear,  or  else  show  her  some 
way  out  of  her  difficulties. 


326    MOKBID  FEAES  AND  COMPULSIONS 

She  gave  him  her  history,  telling  him  particu- 
larly of  her  great  fear  that  she  onght  not  to  marry, 
because,  as  it  seemed  to  her,  she  might  go  insane  at 
any  moment.  Dr.  Dana  stated  in  most  positive 
terms  that  she  w^s  not  going  insane  and  that  she 
need  have  no  fear  on  that  score  of  making  her 
husband  unhappy.  This  comforted  her  for  per- 
haps an  hour,  but  no  longer,  so  in  a  few  days  she 
returned  for  further  assurances.  Dr.  Dana  then 
referred  her  to  me. 

After  this,  as  has  been  said,  Stella  came  to  Cor- 
nell Dispensary  for  nearly  a  year  without  obtain- 
ing any  particular  relief  from  her  fears.  To  be 
sure,  she  was  no  longer  subject  to  the  wild  attacks 
of  crying  and  screaming  which  occasionally  had 
taken  place  during  the  first  few  months  of  her  ill- 
ness, and  certain  minor  obsessive  ideas  connected 
with  her  major  fear  had  apparently  disappeared, 
for  she  ceased  to  talk  of  them.  On  the  whole, 
however,  she  had  made  no  real  improvement. 
These  transitory  obsessive  ideas  should  be  men- 
tioned, for  they  will  be  of  interest  later. 

When  Stella  first  came  to  me  she  feared  not  only 
that  the  fortune  teller  was  able  to  do  Kishef  to 
her,  but  also  that  people  he  knew — his  friends  or 
acqimintances — likewise  had  this  power.  For  this 
reason  she  was  afraid  to  go  to  the  neighborhood  in 
which  he  lived. 

In  this  same  early  period,  Stella  was  also  afraid 
of  any  one  who  looked  at  her  fixedly,  particularly 
strangers.  Thus,  if  she  were  on  the  street  and 
saw  some  one  staring  at  her,  she  would  imme- 
diately fear  that  this  person  was  performing 


A  COMPULSION  NEUEOSIS         327 

magic  on  her  and  that  she  wonld  become  insane  as 
a  result. 

In  a  similar  way  she  was  afraid  of  the  doctor 
who  had  hypnotized  her  at  the  Broadway  Clinic. 
Whenever  she  thought  of  him  she  feared  that  he 
was  doing  Eishef  to  her.  He  was  in  Europe  the 
first  summer  she  came  to  me,  but  the  fact  that  she 
knew  he  was  thousands  of  miles  away  from  her 
did  not  diminish  her  fear  in  the  slightest. 

All  these  ideas  were  never  very  prominent,  and, 
as  I  have  said,  Stella  ceased  to  refer  to  them  after 
a  short  time. 

But  her  main  obsession,  the  fear  of  the  fortune 
teller,  was  remarkable  for  its  intensity.  Appar- 
ently she  was  in  constant  terror  throughout  all 
her  waking  moments.  There  was  practically  noth- 
ing that  would  interest  her  or  take  her  mind  away 
from  herself  more  than  momentarily.  Over  and 
over  again  she  would  say  in  a  certain  stereotyped 
way,  **He  has  power  over  me — ^I'm  afraid  he's 
doing  me  harm — ^I  feel  I^  not  safe — ^he  bosses 
my  thoughts — ^he's  making  me  insane.'' 

She  continually  questioned  me  about  magic  and 
similar  matters.  '^Are  you  sure  there  isn't  any 
magic!"  she  would  ask.  **How  do  you  know 
there  isn't — ^have  you  studied  itt  Is  it  a  scientific 
fact  that  there  can't  be  anyt  There  were  great 
men  in  the  Bible,  and  Shakespeare  was  a  great 
man,  but  they  believed  in  magic  and  witdies — ^how 
do  you  know  they  were  wrong  ?  If  such  bright  men 
beUeved  in  those  things  there  must  be  some  truth 
in  them — ^it  makes  me  afraid — ^I  think  the  Maho- 
shef  has  power  over  me,"  etc. 


328    MOBBID  FEARS  AND  COMPULSIONS 

Any  attempt  I  made  to  reassure  her  on  any  of 
these  points  usually  ended  in  making  her  feel 
worse  rather  than  better.  For  she  would  invari^ 
ably  oomer  me  in  some  way,  and,  as  soon  as  I 
failed  to  give  a  satisfactory  answer,  she  would  be 
in  a  panic. 

Before  her  illness  began  Stella  had  always  ap- 
peared to  possess  a  very  sunny,  fun-loving  dispo- 
sition. Even  during  it  at  times  she  showed  a  keen 
sense  of  humor  and  talked  in  a  very  witty  and 
amusing  way,  but  usually  she  was  greatly  de- 
pressed and  ready  to  cry  at  a  moment's  notice. 
Her  depression,  however,  was  as  nothing  when 
compared  to  her  fear.  Indeed,  I  recall  no  other 
case  of  neurotic  fear  whidi  so  deeply  and  vividly 
impressed  me  with  the  terrible  reality  of  the  pa- 
tient's suffering,  or  in  which  the  familiar  hypo- 
critical note  of  satisfaction  was  so  conspicuously 
absent  from  the  patient's  complainings.  There 
was  no  doubt  whatever  that  Stella  was  really  and 
honestly  sick. 

There  are  many  other  suggestive  circumstances 
which  I  could  have  included  in  this  record  of  his- 
torical data,  but  I  will  omit  all  but  three  which 
seem  most  significant  in  furnishing  the  back- 
ground for  the  problem  at  the  time  of  beginning 
the  analysis.  The  first  of  these  was  Stella's 
intense  and  lasting  rage  when  she  discovered, 
after  her  illness  began,  that  at  the  time  they  first 
went  to  him  Bose  and  Uie  Mahoshef  were  not  total 
strangers  but  had  known  each  other  some  time; 
the  second  was  that  for  some  time  Stella  concealed 


A  COMPULSION  NEUROSIS         329 

from  me  her  dvil  marriage  which  had  taken  place 
a  week  before  she  first  consulted  me.  (Jewish 
people  often  have  a  civil  ceremony  performed  by 
a  city  official  some  little  time  before  the  religious 
ceremony.)  These  two  facts  will  be  accounted 
for  later.     (Pages  403  note  and  424.) 

A  third  matter  which  in  part  was  equally  mys- 
terious, while  at  the  same  time  another  part  gave 
some  hint  of  the  nature  of  Stella's  unconscious 
psychic  process,  was  her  evident  belief  that  if 
Max  had  Eashef  done  to  him  he  would  be  weak 
and  sickly  all  the  rest  of  his  life,  and  could  not 
live  to  be  over  fifty.  Such  credulity  was  entirely 
inconsistent  with  her  attitude  toward  all  other 
superstitious  ideas.  Though  her  obsession,  and 
certain  compulsive  thoughts  connected  with  it, 
represented  a  sort  of  belief  in  superstition,  yet  in 
all  these  instances  her  '^ belief,''  if  it  may  be  so 
called,  was  accompanied  by  an  even  more  positive 
disbelief,  so  that  she  would  say  in  speaking  of 
these  things,  '^I  fear  this  or  that  is  so,  but  I  know 
my  fear  is  perfect  nonsense,"  whereas  in  respect 
to  aU  superstitions  not  related  to  her  morbid  fears 
she  showed  not  a  sign  of  credulity.  But  she  never 
said  that  she  thought  the  prediction  that  Max 
would  be  weak  and  sickly  was  perfect  nonsense, 
while  her  whole  attitude,  in  ways  I  cannot  de- 
scribe in  detail,  thoroughly  convinced  me  that  she 
had  accepted  this  prediction  as  the  absolute  truth. 
In  short,  her  (apparently  real)  belief  that  Max 
would  be  sickly  was  not,  as  in  the  case  of  her  com- 
pulsive superstitions,  accompanied  by  the  simul- 
taneous opposite  feeling  of  disbelief. 


330    MOBBID  FEARS  AND  COMPULSIONS 

But,  although  I  could  not  explain  why  Stella  did 
believe  that  Max  would  be  weak  and  sickly^  yet 
some  of  her  remarks  in  this  connection  disclosed 
the  existence  of  a  conflict,  and  brought  to  light  one 
of  the  several  wishes  or  impulses  which  furnished 
the  motive  power  of  her  obsession.  Thus,  she 
once  remarked,  ''The  thought  that  Max  woidd  be 
a  sick  man  made  me  doubtful  about  marrying  him. 
I  was  crazy  to  have  him,  but  I  didn't  want  to  marry 
a  man  who  was  going  to  be  ill  for  years  and  unable 
to  support  me.  I  felt  that  if  I  married  him,  and 
that  if  he  was  sick  and  had  to  die  anyway,  I  wanted 
him  to  do  it  soon,  and  not  to  wait  until  I  was  so  old 
I  would  have  no  chance  of  marrying  again. ' ' 

Here,  obviously,  was  a  distinct  conflict  Stella 
was  unwilling  to  give  up  Max,  but  she  was  appar- 
ently almost  unwilling  to  be  burdened  for  years 
with  an  invalid  husband,  which,  for  reasons  not 
yet  explained,^  she  believed  Max  would  be.  Un- 
der such  circumstances  she  desired  a  compromise 
— ^namely,  that  Max's  life  would  be  short,  for  if 
she  could  look  forward  to  this,  she  would  neither 
have  to  forego  the  pleasure  of  marrying  him,  nor 
would  she  have  to  bear  indefinitely  the  burden  of 
an  invalid  husband. 

But  we  can  hardly  suppose  that  Stella  could 
have  entertained  a  wish  for  Max's  early  decease 
without  having  a  certain  feeling  of  guilt.  And 
guilt  demands  punishment.  It  seems,  then,  not 
unlikely  that  the  obsession  served  this  purpose, 
among  others.  She  had  wished  for  the  Mahoshef 
to  do  magic  to  Max,  and  she  had  wished  for  Max's 

iSee  page  368. 


A  COMPULSION  NEUEOSIS         331 

death.  What  finer  example  could  be  desired  of 
'Hhat  even-handed  justice  which  commends  the 
ingredients  of  our  poisoned  chalice  to  our  own 
lips"  than  that  as  a  punishment  for  these  wishes 
she  should  have  to  fear  that  the  Mahoshef  was 
doing  magic  to  her,  and  that  she,  too,  was  in  dan- 
ger of  death  t  The  fact,  then,  that  the  obsession 
was  so  well  suited  as  a  punishment  for  what  Stella 
must  have  felt  guilty  of,  makes  it  not  unreasonable 
to  suppose  that  an  impulse  to  penance  and  self- 
punishment  formed  the  first,  though  by  no  means 
the  most  important,  of  its  determinants. 

(c)  PreUmmary  Survey 

Before  proceeding  to  report  the  results  obtained 
during  the  period  in  which  Stella  was  under  analy- 
sis it  may  be  well  to  state  the  problem  as  I  saw  it 
at  the  beginning  of  this  treatment. 

To  those  who  hold  to  the  suggestion-theory  of 
the  genesis  of  obsessions,  this  history,  as  I  have 
related  it,  presents  no  conspicuous  problems.  A 
young  woman  of  neurotic  and  presumably  impres- 
sionable temperament,  brought  up  among  ex- 
tremely fanatical  and  superstitious  people,  de- 
velops a  neurosis  during  the  strain  and  excitement 
incident  upon  an  unsatisfactory  love  affair.  This 
neurosis,  judging  from  its  content,  is  simply  a  re« 
awakening  of  a  belief  in  magic  which  she  enter- 
tained as  a  child.  The  visit  to  the  fortune  teller 
and  the  various  remarks  of  the  superstitious 
cousin — occurring,  as  they  did,  when  the  young 
woman  was  in  a  very  excitable  condition — ^would 
be  looked  upon  as  sufficiently  influential  to  bring 


332    MORBID  FEABS  AND  COMPULSIONS 

about  the  reawakening,  and  thns  canse  the  nenro- 
sb.  From  roch  a  viewpoint  the  case  is  little  more 
than  a  simple  equation.  Neurotic  predisposition, 
environmental  influences,  an  event  of  presumably 
high  suggestive  value — ^all  three  factors  tending 
in  the  same  general  direction — ^produce,  when 
added  together,  an  obsessive  fear.  What  could  be 
plainer t    The  case  explains  itself! 

The  psychoanalyst,  however,  would  see  in  this 
history  many  points  that  call  for  extensive  and 
earefid  investigation,  and  would  feel  utterly  at  a 
loss  to  explain  the  obsession  without  knowing  a 
great  deal  more  about  the  patient's  life  than  has 
yet  been  recorded.  Nevertheless,  he  might  read- 
ily find  in  the  material  at  hand  matters  whidi 
would  lead  to  interesting  speculations  as  to  the 
etiology  of  the  neurosis,  and  would  give  some  hints 
both  as  to  the  nature  of  the  problems  confronting 
him  and  as  to  the  sort  of  causal  factors  which  he 
might  expect  to  find. 

For  instance,  it  appears  that  the  patient  became 
sick  ui  the  midst  of  a  love  affair,  improved  as  soon 
as  it  ended,  but  again  became  sick  shortly  after 
entering  into  an  experience  with  another  lover.  Is 
this  correlation  between  romance  and  illness  to 
be  looked  upon  as  accidental  or  as  causal  t  And 
if  the  latter,  what  sort  of  causes  might  be  at 
work? 

On  theoretical  grounds  we  may  give  partial  and 
tentative  answers  to  these  questions.  A  neurosis, 
as  Jung  has  said,  invariably  expresses  some  trend 
of  thought  and  feeling  away  from,  or  hostile  to,  the 
individuals  who  stand  in  closest  psychological  re- 


A  COMPULSION  NEUROSIS         333 

lation  to  the  patient.^  Sndi  a  position  was  once 
oocapied  by  Max,  later  by  Barney.  We  may  there- 
fore infer  that  some  sort  of  emotional  confliot 
existed  in  the  mind  of  the  patient  in  regard  to 
these  two  persons — ^that  for  some  unknown  reason 
it  was  impossible  for  her  to  adjust  herself  per- 
fectly to  either  one  of  them,  and  that  this  non- 
adjustment  had  to  do  with  the  outbreak  of  the 
neurosis. 

And  this  view  is  supported  when  we  oome  to  ex- 
amine certain  facts  already  at  our  command.  For 
example,  Stella's  love  for  Max  was  apparently 
pathological.  It  began  as  a  typical  case  of  '^love 
art  first  sight. ''  Although  this  phenomenon  is  per- 
haps normal  enough  in  stories,  it  is  seldom  so  in 
real  life.  The  condition,  judging  from  the  few 
cases  I  have  had  a  chance  to  study,  is  always  a 
compulsion.  The  patient  has  formed  a  strong 
love-fixation — ^usually  upon  some  individual  of 
high  significance  in  the  years  of  childhood — ^but 
this  fixation  becoming  for  some  reason  offensive 
to  the  patient's  conscious  personality  has  been  sub- 
jected to  repression  and  driven  more  or  less  com- 
pletely from  consciousness.  The  phenomena  of 
love  at  first  sight  represent  either  a  transference 
— ^usually  incomplete — of  this  love,  now  partly  jor 
wholly  unconscious,  to  some  new  love-object, 
against  whom  there  are  no  particular  conscious 


I  "Analytical  Psychology,'*  p.  120.  As  a  matter  of  fact  the  per- 
flons  to  whom  Stella  stood  is  closest  psychological  relation  were 
her  parents,  and  her  neurosis  showed  that  she  was  as  poorly 
adjusted  to  them  as  she  was  to  Max  and  Barney.  But  the  matter 
^f  her  adjustment  to  her  parents  is  one  that  for  the  moment  we 
need  not  consider,  although  we  shaU  take  it  up  later. 


334    MORBID  FEAES  AND  COMPULSIONS 

resistanoeSy  or  else  a  flight  from  the  old  love-ob- 
ject, or  a  combination  of  both  transference  and 
flight.  In  any  case,  the  person  apparently  loved 
is  not  the  person  actually  loved,  though  in  time,  in 
some  cases,  a  complete  transference  may  take 
place. 

If  we  now  apply  these  principles  to  Stella's  case, 
our  conclusion  would  be  that  Stella  seemed  to  love 
Max  so  much,  simply  because,  in  some  unhnofvn 
way,  he  represented  a  substitute  for,  or  a  flight 
from,  some  one  else  with  whom  she  was  actually 
in  love,  although  probably  she  would  not  permit 
herself  to  realize  it.^ 

Incidentally,  if  the  foregoing  conclusions  are 
correct,  certain  other  features  of  her  affair  with 
Max  become  comprehensible.  Thus,  though  ladies 
in  story  books  are  supposed  to  lose  flesh  and  appe- 
tite, and  to  spend  long  hours  in  weeping  whenever 
they  fall  in  love,  we  cannot  regard  these  manifes- 
tations as  normal  accompaniments  of  love  in  real 
life.  If,  however,  we  are  right  in  supposing  that 
Stella's  love  for  Max  was  either  an  imperfect 
transference  or  a  flight,  these  morbid  phenomena 
are  not  so  difficult  to  understand.  That  is,  if, 
while  she  was  consciously  scheming  to  marry  Max, 
she  was  unconsciously  in  love  with  some  one  else 
she  had  good  reason  to  be  depressed. 

Other  signs  indicated  a  lack  of  adjustment  in 
Stella 's  relations  with  Barney.  It  did  not  require 
a  long  acquaintance  with  Stella  to  convince  me 

iThis  does  not  meui,  of  courfle,  that  aR  her  seeming  lore  for 
Max  had  this  origin— HBerely  that  a  part  of  it  did,  jparticnlarly  at 
first. 


A  COMPULSION  NEUKOSIS         335 

that  she  felt  toward  Barney  none  of  the  mad  in- 
fatuation which  she  seemed  to  have  experienced 
for  Max.  For  instance,  whenever  she  talked  of 
Max  her  face  would  light  up,  and,  for  the  moment 
forgetting  her  fears,  she  would  plunge  into  the 
most  vivid  and  enthusiastic  description  of  him 
imaginable.  **0h,/'  she  would  say,  **he  was  so 
refined  I  How  I  loved  him  I  I  thought  I  'd  die  if  I 
couldn't  be  his  wife.  If  I  could  have  married  him 
I  would  have  been  contented  to  live  in  only  one 
room  all  the  rest  of  my  days.'' 

But  when  she  spoke  of  Barney  there  was  a  great 
difference.  ' '  Of  course  I  love  Barney, ' '  she  would 
say  in  a  somewhat  argumentative  tone,  as  if  ex- 
pecting immediate  contradiction  from  some  in- 
visible hearer :  "I  love  him  as  a  friend.  My  feel- 
ing for  him  is  geistliche  lAebe — ^not  Leidenschaft 
He  is  intelligent  and  refined  and  I  respect  him — 
yes,  I  have  the  greatest  respect  for  him."  But 
these  protestations  were  accompanied  by  none  of 
the  enthusiastic  animation  that  characterized  her 
references  to  Max. 

It  was  quite  evident,  then,  that  she  felt  for  Bar- 
ney a  much  less  intense  love  than  she  appeared  to 
feel  for  Max.  But  a  still  more  positive  conclusion 
in  regard  to  this  matter  could  be  drawn.  If  an 
emotional,  neurotic  girl,  on  the  very  eve  of  her 
wedding,  cannot  work  herself  up  to  the  point  of 
saying  of  her  betrothed  something  more  enthu- 
siastic than,  **I  love  him  as  a  friend — ^I  respect 
him,"  one  need  have  little  doubt  as  to  the  true 
state  of  her  feelings — ^in  all  probability  she  does 
not  love  him  at  all. 


336    MORBID  PEAES  AND  COMPULSIONS 

In  fall  accord  with  this  condosion  is  another 
matter  that  has  already  been  mentioned.  Stella 
felt  that  she  was  doing  wrong  in  getting  married, 
and  that  she  was  almost  certain  to  make  her  hus- 
band unhappy.  To  be  sure,  these  ideas  appeared 
to  be  a  logical  result  of  her  fears.  Seemingly,  she 
thought,  ^'I  am  going  insane,  and  therefore  1  ought 
not  to  marry — insanity  will  be  the  means  of  my 
bringing  trouble  upon  my  husband. '^  But  psy- 
choanalytic experience  shows  quite  conclusively 
that  a  compulsive  idea,  or  any  similar  symptom,  is, 
generally  speaking,  never  the  cause  of  anything 
— it  is  always  an  effect.^  We  may  conclude, 
therefore,  that,  in  Stella's  case,  her  feeling  that 
she  ought  not  to  marry,  and  that  she  would  make 
her  husband  unhappy,  depended  not  upon  her  ob- 
session, but  upon  some  other,  concealed  factor, 
which  adequately  justified  this  feeling.  In  other 
words,  there  must  have  been  some  good  reason 
why  she  should  not  marry  Barney,  although  ap- 
parently she  would  not  frankly  admit  this  to  her- 
self. This  reason  was,  perhaps,  that  she  did  not 
love  him,  but  did  love  some  one  else. 

But  if  we  continue  these  speculations  we  are 
in  great  danger  of  falling  into  the  error  of  feeling 
that  we  understand  the  case  when  we  have  only 
begun  to  study  it.  Let  us,  therefore,  enter  as 
soon  as  possible  into  an  examination  of  the  ma- 

ilf,  for  eacample,  a  man  develops  a  neuroUc  ■ymptom  which 
apparently  caueee  him  to  be  unable  to  continue  hli  businessy  we 
are  likely  to  find  upon  analysis  that  for  some  reason  the  man 
vocmted  to  give  up  hi9  huuvnesB,  and  that  this  wish  was  the  imme- 
diate cause  of  his  doing  so. 


A  COMPULSION  NEUROSIS         337 

terial  brought  out  by  my  analysis,  for  by  this 
means  any  danger  of  our  feeling  prematurely  that 
we  understand  the  neurosis  will  soon  be  effectu- 
ally dispelled.  Incidentally,  it  should  be  re- 
marked at  this  point  that  iim&  far  I  have  given 
Stella's  history  as  I  received  it — not  as  I  know  it 
now — ^and  that  we  may  be  prepared  to  find  it  in 
many  respects  erroneous,  misleading,  and  incom- 
plete. 

Paet  II.    Akalytio 
(a)  The  Father-Complex 

When  I  had  finally  decided  to  begin  the  analy- 
sis I  informed  Stella  that  I  wished  to  try  a  new 
treatment — one  which  would  require  her  fullest 
cooperation  to  be  a  success — and  that  her  part 
would  be  to  perform  the  difficult  task  of  follow- 
ing a  very  simple  rule,  viz.,  to  tell  everything  that 
came  to  her  mind,  whether  or  not  the  thought 
seemed  to  her  pleasant  or  unpleasant,  important 
or  unimportant. 

Having  heard  this  solemn  injunction,  Stella  be- 
gan to  laugh. 

*  *  That 's  silly, '  *  she  said.  *  *  That  will  never  cure 
me.  Anyway,  you  know  all  about  me  already. 
What  more  can  I  tell  youT" 

But,  after  a  few  moments,  she  began  to  talk 
about  her  mother. 

**My  mother,*'  she  said,  **i8  a  very  nervous 
woman.  She  is  just  like  I  am ;  she  isn  't  well.  I 
am  more  fond  of  my  mother  than  of  any  one  else 
in  the  world.    Whenever  she  is  out  of  my  sight  I 


338    MORBID  PEAES  AND  COMPULSIONS 

worry  about  her  and  fear  something  will  happen 
to  her — that  she  may  get  sick  or  be  killed  in  an 
accident. ' ' 

I  felt  that  my  acquaintance  with  Stella  had 
lasted  long  enough  to  allow  me  to  venture  some 
comment  on  these  remarks.  I  began  by  saying 
that  not  all  that  goes  on  in  our  minds  is  accom- 
panied by  consciousness ;  thus,  we  could  have  va- 
rious impulses  or  wishes  of  quite  considerable 
strength  without  being  clearly  aware  of  them. 
Such  wishes  sometimes  presented  themselves  in 
consciousness  in  the  shape  of  fears. 

But  at  this  point  Stella  interrupted  me. 
**WhatP*  she  cried  excitedly,  **do  you  mean  that 
I  hate  my  mother,  that  I  want  her  to  die!" 

I  said  I  was  not  able  to  deny  that  such  a  condi- 
tion of  affairs  might  exist  and  asked  her  what  she 
thought  about  it. 

**0h,  I  know  you  are  wrong, '*  she  exclaimed;  "I 
love  my  mother  and  always  wilL  If  she  died,  I 
would  want  to  die,  too. ' ' 

To  this  I  replied  that  the  existence  of  a  very 
great  love  would  not  necessarily  disprove  the  co- 
existence of  an  opposite  feeling.  Stella  paid  no 
attention  to  this,  however,  and  in  a  somewhat  il- 
logical way  continued  her  protests.  At  this  point 
we  were  interrupted  and  had  to  defer  the  discus- 
sion to  the  next  setting. 

At  the  next  visit  she  immediately  began  with 
the  question,  ^'What  could  make  me  hate  my 
mother!*' 

**I  cannot  say,*'  I  replied;  **what  do  you  think 
about  it!*' 


A  COMPULSION  NEUBOSIS         339 

She  answered  that  she  cotdd  offer  no  explana- 
tion ;  but,  after  a  considerable  pause,  she  suddenly 
said,  ^^  Doctor,  there  is  something  I  think  I  ought 
to  tell  you.    My  father  used  to  touch  me/' 

When  I  asked  her  to  explain  this  remark  she 
finally  furnished  me  with  the  following  informa- 
tion. When  she  was  about  twelve  years  old  her 
father  began  a  practice  of  coming  to  her  bed  at 
night,  fondling  and  caressing  her  quite  amorously, 
and  placing  his  hand  upon  her  breasts  and  geni- 
tals. This,  Stella  frankly  admitted,  had  excited 
her  greatly ;  and,  though  she  had  protested  against 
these  practices,  she  had  always  enjoyed  them. 
She  added,  in  explanation,  that  up  to  the  time 
her  obsessions  began  she  had  always  been  ex- 
tremely passionate  and  easily  excited. 

Her  father's  visits  had  continued  two  or  three 
times  a  week  until  she  was  somewhere  between  six- 
teen and  nineteen  years  of  age,  when  they  ceased, 
but  exactly  when  or  under  what  circumstances 
Stella  professed  to  be  unable  to  remember.  I 
can,  however,  supply  the  missing  information  from 
what  I  learned  much  later  in  the  analysis.  When 
she  was  seventeen  and  a  half  years  old  a  number 
of  friends  were  staying  at  her  house,  in  conse- 
quence of  which  Stella  slept  in  a  different  room 
from  her  usual  one.  In  the  middle  of  the  night 
she  was  suddenly  awakened  by  her  father's  stand- 
ing over  her  bed  and  fumbling  with  her  bedclothes. 
Not  recognizing  him  for  the  moment,  and  being 
confused  at  not  finding  herself  in  her  own  room, 
she  was  very  much  frightened ;  but,  when  she  did 
realize  who  it  was,  her  fear  was  changed  to  anger 


340    MOEBID  FEARS  AND  COMPULSIONS 

for  the  fright  he  had  given  her.  '^  Why  can 't  yon 
leave  me  alone  I"  she  said  indignantly.  ^^Dont 
ever  do  that  to  me  again!  I've  had  enongh  of 
your  nonsense. " 

^^Gan't  a  father  kiss  his  own  daughtert"  he  re- 
plied. '^  Anyway,  I  was  only  trying  to  see  that 
you  were  covered  warmly  enough." 

^^That  is  not  so,''  returned  Stella.  ^^If  you 
must  amuse  yourself ,  why  don't  you  go  to  my  sis- 
tert  If  you  ever  try  to  touch  me  again,  I  swear  I 
will  tell  my  mother!" 

This  threat  seemed  to  have  its  effect,  for  her 
father  never  ventured  to  resume  his  visits.  SteUa 
had  often  protested  against  them  before,  but  this 
was  the  first  time  she  had  threatened  to  tell. 

I  trust  that  it  is  now  plain  that  Stella  had  an- 
swered the  question  of  why  she  ^^ hated"  her 
mother.  This  hate,  if  it  may  be  so  called,  de- 
pended upon  her  attachment  to  her  father.  The 
fears  that  her  mother  would  die,  etc.,  were  part  of 
the  wish  phantasy,  which,  as  I  later  learned,  she 
had  often  entertained  consciously,  that  her  mother 
would  die,  in  order  that  she  might  assume  the 
mother's  place  with  the  father.  These  death 
wishes  and  feelings  of  hate  existed  in  spite  of  a 
well-developed  love  for  the  mother.  Let  me  again 
emphasize  that  the  ability  to  entertaiu  simultan- 
eously the  two  opposite  feelings  of  love  and  hate, 
with  a  high  degree  of  intensity  and  toward  the 
same  person,  is  one  of  the  prominent  characteris- 
tics of  compulsion  neurotics.  In  them  love  and 
hate  may  coexist  indefinitely,  instead  of  one  drown- 
ing out  the  other  as  would  normally  be  expected  to 


A  COMPULSION  NEUROSIS         341 

occar.  The  opposed  feelings  in  these  oases  are 
not  as  a  rale  simnltaneously  eonscious.  The  hate 
is  usually  confined  more  or  less  successfully  to  the 
unoonscious,  and  the  conscious  and  f  oreconscious 
love  becomes  overdeveloped  to  serve  as  a  reaction 
and  a  cover  for  it. 

A  great  deal  more  could  very  well  be  said  of 
Stella's  father-complex,  which,  it  should  be  evi- 
dent to  any  one,  must  have  been  extremely  strong. 
I  will  not  pursue  this  subject,  however,  simply  for 
the  lack  of  space,  as  there  is  so  much  else  that  re- 
quires discussion.  We  shall  later  hear  more  of 
the  effect  of  this  complex. 

(6)  The  SeparationrComplex 

The  next  matter  that  came  into  prominence  in 
my  talks  with  Stella  was  the  question  of  her  feel- 
ing and  attitude  toward  her  husband.  Even  be- 
fore beginning  the  analysis  I  had  come  to  the  con- 
clusion that  she  cared  little  for  Barney  and  had 
asked  myself  why  she  had  married  him.  The 
question  became  even  more  puzzling,  for  I  learned 
that  while  she  had  been  receiving  attention  from 
Barney,  Stella  had  had  still  another  suitor,  upon 
whom  she  had  looked  with  much  more  favor.  This 
man,  whom  I  will  call  Lehmann,  was  not  only 
much  better  looking  than  Barney,  but,  in  addition, 
he  was  a  manufacturer  in  most  comfortable  cir- 
cumstances, while  Barney  was  practically  penni- 
less. Lehmann  was  madly  in  love  with  Stella, 
and  his  family  would  have  looked  with  favor  upon 
the  match.  And  so  I  felt  sure  she  would  have 
much  rather  married  Lehmann  than  Barney,  though 


342    MOEBID  TEAES  AND  COMPULSIONS 

whether  she  would  have  preferred  Lehmann  to 
Max  I  was  not  certain.  The  question  of  why  she 
married  Barney  was,  then,  greater  than  before.^ 

Early  in  the  analysis  Stella  had  a  dream,  which, 
although  throwing  some  light  on  the  problems 
in  the  case,  seemed  at  first  to  add  to  them  rather 
than  otherwise.  The  dream  was  simply  that  a 
certain  recently  married  woman  had  left  her  hus- 
band, then  residing  in  Boston,  and  come  to  New 
York. 

This  dream  was  a  reproduction  of  an  actual 
fact  that  had  occurred  in  Stella's  experience.  The 
woman  referred  to,  after  living  with  her  husband 
only  a  few  weeks,  had  run  away  from  him  and  re- 
turned to  her  parents  in  New  York. 

We  are  familiar  with  the  observation  that  the 
chief  actor  in  the  dream  is  practically  always  the 
dreamer.  With  the  woman  of  the  dream  Stella 
could  readily  identify  herself,  for  both  had  worked 
in  the  same  store  and  both  had  been  married  for 
only  a  short  time.  One  could  suppose,  then,  that 
the  woman  represented  none  other  than  Stella 
herself.  Stella  dreamed,  then,  that  she  followed 
the  example  of  her  friend;  and  this  could  only 
mean  that  she,  too,  had  a  wish  to  leave  her  hus- 
band and  return  to  her  parents. 

1 1  ahould,  perhaps,  state  at  this  point  that  this  and  similar 
questions  that  came  up  in  the  analysis  I  sulmitted  to  Stella  in 
the  hope  that  she  would  answer  them.  It  was  quite  uselessy  how* 
ever,  for  she  would  either  reply  that  she  ''did  not  know^  or  else 
would  give  some  evasive  explanation  which  it  was  quite  impossi* 
ble  to  accept.  For  instance,  many  times  she  maintalniwi  that  she 
had  married  Bam^  for  love  alone,  whereas  at  other  times  her 
own  admission,  as  well  as  many  other  indications,  showed  ttiat 
this  explanation  was  entirely  incorrect. 


i 


A  COMPULSION  NEUROSIS         343 

Hoping,  however,  to  find  some  more  significant 
source  of  identification  than  that  just  mentioned  I 
asked  Stella  to  tell  me  more  about  the  woman. 
She  responded  by  informing  me  that  the  woman 
was  very  fat,  while  her  husband  was  quite  the  re- 
verse ;  and  then  added  this  most  singular  remark, 
''J  thif^  she  was,  too  strong  for  him/' 

What  Stella  meant  by  this  I  had  not  the  slight- 
est idea,  so  I  asked  at  last  if  she  had  used  the 
phrase  in  some  sexual  sense,  and  to  this  she  as- 
sented with  such  alacrity  that  I  was  quite  sure 
she  had  meant  nothing  of  the  kind — ^that  is  to  say, 
I  felt  she  was  unwilling  to  explain  exactly  what 
she  had  in  mind,  and  so  when  I  had  suggested  that 
it  was  something  sexual  she  readily  agreed,  think- 
ing this  would  satisfy  me  and  that  I  would  press 
her  no  further.  Being  now  quite  convinced  that 
there  was  some  really  important  reason  for  Stella's 
identifying  herself  with  the  woman,  and  that  it 
probably  was  contained  in  her  relations  with 
Barney,  I  asked,  "Did  you  ever  feel  that  you 
were  too  strong  for  Barney  f 

**Tes,'*  she  answered  rather  reluctantly  and 
would  say  nothing  more. 

I  kept  on  questioning  her  and  finally  brought  to 
light,  first,  that  Barney  suffered  from  ejactdatio 
pracox,  and,  second,  the  following  matter,  which 
seemed  even  more  important.  Barney  had  suf- 
fered several  attacks  of  gonorrhea  before  his 
marriage.  A  short  time  before  I  began  the  analy- 
sis he,  discovering  what  he  believed  to  be  a  return- 
ing gleet,  had  consulted  a  doctor,  who  for  some 
reason  examined  his  semen  and  told  him,  in 


344    MOBBID  FEABS  AND  COMPULSIONS 

Stella's  presence,  that  in  all  probability  he  was 
sterile  and  would  remain  so.  This  was  very 
painf nl  to  Stella,  for,  as  she  then  told  me,  she 
was  extremely  anxions  to  have  children,  not  only 
because  she  was  most  fond  of  them,  but  also  be- 
cause, as  she  expressed  it,  to  have  them  would 
make  her  marriage  stronger. 

I  was  not  at  all  convinced  that  the  information 
I  had  obtained  had  exhausted  the  significance  of 
the  dream,  and  I  was  even  in  doubt  as  to  whether 
all  of  it  had  to  do  with  the  dream,  because,  as 
I  had  broken  in  with  questions,  I  could  not  regard 
all  of  Stella's  statements  as  free  associations. 
At  any  rate,  whether  connected  or  not,  both  the 
information  I  brought  out  and  the  dream  were 
evidently  of  no  small  importance.  The  dream 
showed  plainly  enough  that  Stella  had  a  wish  to 
separate  from  her  husband,  but  whether  this  arose 
from  the  mere  fact  that  he  was  sterile,  .or  whether 
there  were  other  reasons  for  it,  could  not  at  the 
time  be  determined. 

I  told  Stella  that  I  interpreted  the  dream  as 
an  expression  of  a  wish  on  her  part  to  leave  her 
husband,  but  she  promptly  disputed  this,  say- 
ing, ^^I  will  never  want  to  separate  so  long  as  we 
are  both  alive.'*  But,  as  this  sounded  to  me  as 
if  she  had  an  alternative  in  mind,  I  said,  ^^Do 
you  mean  that  you  would  like  him  to  die  and  free 
youf 

"No,'*  she  replied  instantly,  "I  do  not  wish  him 
dead";  but,  after  a  pause,  she  suddenly  said,  ^'I 
am  not  going  to  lie  to  you ;  I  have  wished  him  dead, 
often.    This  morning  when  I  was  washing  his 


A  COMPULSION  NEUEOSIS         345 

clothes  I  swore  to  myself  and  said  that  I  wished 
they  were  his  death  clothes. ' ' 

She  went  on  to  say,  however,  that  she  did  not 
feel  this  way  all  the  time.  ^^When  he  is  nice  to 
me,  and  when  I  think  we  can  go  ahead  and  make 
money,  keep  up  a  nice  home,  and  maybe  have 
children,  I  feel  that  I  can  love  him  and  I  do  not 
wish  him  dead;  bnt,  when  he  is  m€fan,  I  hope  he 
will  die  right  away.  Usoally,  when  I  wish  him 
dead,  I  am  sorry  afterwards  and  think  maybe  I 
will  be  punished  for  such  thoughts." 

It  was  not  until  after  this  communioation  that 
Stella  told  me  of  a  new  detail  of  her  fears.  It 
seemed  that  before  her  marriage  she  was  afraid  to 
let  any  one  know  about  her  illness  for  fear  that 
it  would  come  to  Barney's  ears  and  he,  thinking 
her  either  insane  or  about  to  become  so,  would 
withdraw  from  the  engagement.  After  her  mar- 
riage she  was  even  more  afraid  that,  as  a  result 
of  magic,  she  would  become  insane  and  he  would 
then  be  able  to  divorce  her.  After  she  had  once 
told  me  this  detail,  it  became  one  of  the  most  fre- 
quent themes  in  Stella's  conversation.  She  con- 
tinually asked  me  to  assure  her  that  she  was  not 
insane ;  she  did  all  sorts  of  things  for  fear  people 
would  think  her  so ;  she  would  never  admit  to  any 
one  that  she  felt  ill  in  any  particular  for  fear  they 
would  immediately  conclude  that  she  was  losing 
her  mind ;  and  she  was  never  tired  of  questioning 
me  in  regard  to  the  laws  relating  to  insanity  and 
divorce.  She  was  particularly  distressed  by  the 
fact  that  her  history  was  on  file  at  the  Broadway 
Clinic  and  similar  places. 


346    MORBID  FEARS  AND  COMPULSIONS 

**I  know/'  she  would  say,  "if  that  history,  in 
which  it  is  written  that  I  went  to  a  fortune  teller 
and  then  thought  I  was  insane,  was  brought  into 
court,  the  judge  and  jury  would  surely  believe  I 
really  was  insane  and  give  Barney  a  divorce  in  a 
minute." 

When  I  reminded  her  that  all  the  doctors  she 
had  consulted  had  instantly  told  her  she  was  not 
insane  or  ever  likely  to  be,  she  would  reply;  "I  am 
afraid  if  it  came  to  court  they  would  change  their 
minds/'  **I  don't  believe  they  would  stick  to 
what  they  said."  "I  am  afraid  they  would  go 
back  on  me. "  *  *  Maybe  they  were  afraid  to  tell  me 
the  truth,  anyway,"  eta 

I  noticed  that  she  talked  more  about  her  history 
at  the  Broadway  Clinic  than  about  any  of  the 
other  histories  and  seemed  ever  so  much  more 
anxious  over  it.  She  was  continually  planning 
to  go  to  this  Clinic  and,  on  pretense  of  requiring 
treatment,  get  hold  of  her  history  and  tear  it  up, 
but  she  never  planned  to  do  this  with  the  history 
at  the  neurological  hospital  or  at  Cornell.  In- 
deed, many  times  she  started  for  the  Broadway 
Clinic,  intending  to  do  away  with  the  record,  but 
on  the  way  would  come  the  reflection,  "Maybe  it 
would  look  worse  if  I  did  tear  it  up— maybe  peo- 
ple would  think  I  did  it  because  I  knew  I  was  in- 
sane and  was  trying  to  destroy  the  proof,"  eta, 
and  thus  she  never  got  to  the  point  of  putting  her 
plan  into  execution.^ 

1  This  element  of  her  fear,  namely,  that  by  means  of  the  history 
at  the  Broadway  Clinic  it  would  be  proved  that  she  was  inhume, 
etc.|  is  what  I  had  in  mind  particularly  when,  in  the  introdnctkOt 


A  COMPXJLSION  NEUEOSIS         347 

Two  Bets  of  reproaches,  quite  similar  in  content 
to  the  obsessive  fear  that  she  would  be  divorced 
she  frequently  made  against  her  husband.  The 
first  originated  in  the  fact  that  he  had  once  lived 
in  the  same  house  with  a  young  woman  named 
Ada,  who  apparently  would  have  liked  very  much 
to  marry  him,  although  there  is  no  reason  to  sup- 
pose he  reciprocated  this  feeling.  That  he  was  in 
all  probability  utterly  indifferent  to  Ada,  Stella  in 
her  '^ sober  moments''  seemed  to  know  as  well  as 
any  one.  Nevertheless,  the  greater  part  of  the 
time  she  was  loud  in  her  complaints  that  Barney 
oared  nothing  for  herself  but  was  only  waiting 
until  she  should  become  insane  so  that  he  could 
divorce  her  and  marry  Ada. 

**He  is  no  man!*'  she  would  cry.  ** Anybody 
else  would  stick  by  a  wife  if  she  got  sick,  but  he 
wouldn't!  As  soon  as  he  found  he  could  prove 
me  insane  he  would  do  it,  and  get  rid  of  me  as 
quickly  as  possible." 

These  complaints,  uttered  in  the  most  spiteful, 
angry  tones  imaginable,  Stella  repeated  hundreds 
of  times ;  and,  when  she  was  in  the  mood  for  com- 
plaining, no  argument  could  make  her  see  what  at 
other  times  she  freely  admitted,  viz.,  that  her  ac- 
cusations were  entirely  without  foundation. 

Another  set  of  reproaches  against  Barney  re- 
ferred to  his  attitude  in  money  matters.  She  con- 
tinually complained  that  he  was  mean  and  stingy, 

I  spoke  about  diBplacement  aa  ahown  by  this  case.  We  shall  see 
eventually  that  her  anxiety  about  her  history  at  this  clinic  was 
indeed  well  founded,  but  that  the  foundation  for  it  was  some- 
thing entirely  different  from  what  appeared  in  her  obsession. 


348    MORBID  FEAES  AND  COMPULSIONS 

that  he  insisted  on  her  working  at  the  store  when 
she  should  have  been  caring  for  things  at  home. 
She  was  particularly  venomous  over  the  recollec- 
tion that  one  time  he  nmde  her  go  to  work  in  a 
snowstorm,  when,  in  her  opinion,  the  weather  was 
so  bad  that  she  should  have  stayed  at  home.  ''I 
might  easily  have  caught  pneumonia  and  died 
from  being  out  on  a  day  like  that,''  she  said,  "but 
he  wouldn't  care.  A  few  pennies  are  more  to 
him  than  my  health  and  life.  The  only  thing  he 
married  me  for  was<that  I  should  work  for  him." 

As  a  matter  of  fact,  her  husband  did  insist  upon 
her  working  at  times,  but,  apparently,  not  from 
choice.  Financial  conditions  were  bad;  he  had 
little  work ;  and  what  she  could  earn  was  not  only 
a  very  acceptable  addition  to  the  family  income 
but  at  times  an  absolutely  necessary  one.  He,  as 
in  a  way  she  really  well  knew,  did  not  demand  of 
her  anytliing  that  other  men  in  the  same  walk  of 
life  did  not  expect  from  their  wives. 

That  Stella 's  complaints  were  absolutely  unfair 
and  unreasonable  no  one  was  in  a  better  position 
to  know  than  herself.  Why,  then,  could  she  not 
take  a  reasonable  view  of  the  situation  and  give 
up  her  unjust  complaining  ?  The  obvious  explana- 
tion that  she  wanted  to  think  her  husband  at  fault 
in  these  matters — ^that  it  gave  her  some  sort  of 
comfort  or  satisfaction  to  be  able  to  accuse  him 
in  this  wise.  But  why  should  this  sort  of  thing 
give  her  satisfaction?  This  question,  to  any  one 
with  a  little  analytic  experience,  is  not  difficult  to 
answer.  She  must  have  felt  herself  guilty  of  the 
same  things  for  which  she  reproached  her  hus- 


A  COMPULSION  NEUEOSIS         349 

band.  This  defense  mechanism  is  a  very  familiar 
one  and  has  been  referred  to  earlier  in  Chapter  IV. 
Stella's  reproaches  against  her  husband  could, 
then,  be  applied  to  herself ;  and  this  means,  first, 
that  she  had  the  intention  of  getting  rid  of  her 
husband  and  marrying  some  one  else,  and,  second 
(since  she  reproached  her  husband  with  being  too 
interested  in  money  matters),  that  some  financial 
or  economic  condition  must  have  interested  her 
more  than  she  felt  was  right.  This  interest  per- 
haps, in  some  unknown  way,  had  been  a  factor  in 
bringing  about  their  marriage;  possibly  she  had 
married  Barney  merely  to  have  some  one  to  sup- 
port her. 

It  is  to  be  observed  that  Stella's  complaint  that 
her  husband  wished  to  get  rid  of  her  is  quite  in 
harmony  with  the  dream  just  analyzed.  Both 
indicated  that  Stella  wished  or  intended  her  mar- 
riage to  Barney  to  be  only  temporary.  She  would 
not  admit,  however,  that  she  wished  for  a  sep- 
aration, although,  as  the  analysis  progressed,  she 
ehowed  little  hesitation  in  confessing  that  the 
greater  part  of  the  time  she  most  heartily  wished 
her  husband  was  dead.  That  she  really  did  wish 
for  a  separation,  perhaps  as  an  alternative  less 
acceptable  than  her  husband's  death,  I  firmly  be- 
lieved in  spite  of  her  denials.  Indeed,  I  was  dis- 
posed to  think  that  this  wish  was  a  determinant 
of  her  fears  that  through  the  fortune  teller's  Kis- 
hef  she  would  become  insane  and  be  divorced. 
But  as  I  was  in  no  position  to  prove  my  point  I 
had  to  let  the  matter  drop  for  the  time. 

Before  leaving  the  theme  of  Stella's  reproaches 


350     MOEBID  FEAES  AND  COMPULSIONS 

against  others,  I  must  take  up  her  attitude  toward 
her  husband's  sister.  This  girl  originally  had 
been  one  of  her  closest  f  riends,  but  Stella  had  not 
been  married  very  long  when  they  began  to  quar- 
rel most  frightfully.  It  was  plain  to  be  seen,  how- 
ever, that  these  quarrels  were  really  Stella's  fault. 
They  usually  originated  from  her  making  without 
the  slightest  provocation  some  unreasonable  and 
unjust  accusation  against  her  sister-in-law.  One 
thing  which  seemed  to  be  concerned  with  Stella's 
inclination  to  pick  these  quarrels,  and  to  which 
she  frequently  referred  during  her  visits  to  me, 
was  this.  It  seems  that  shortly  before  her  mar- 
riage, Stella  on  the  advice  of  some  doctor  and 
contrary  to  her  own  inclination,  had  told  Barney 
of  the  obsession  from  which  she  suffered,  and  he  in 
turn  had  told  his  sister.  (I  should  add  here  that 
Stella  promptly  repented  of  her  confession  and 
soon  after  her  marriage  told  her  husband  the  ob- 
session had  entirely  disappeared.)  Some  time 
after  they  were  married  Barney  was  out  of  the 
city  for  a  few  days,  and,  as  it  so  happened,  his  de- 
parture had  followed  closely  upon  an  argument  in 
which  Stella,  his  sister,  and  himself  were  all  in- 
volved. During  his  absence  his  sister  wrote  him 
a  letter  which  Stella,  prying  through  his  things 
upon  his  return,  found  and  read.  This  interest- 
ing document  contained  among  other  matters  the 
following  words:  ^^That  girl  (Stella)  was  insane 
when  you  married  her.  Maybe  she  isn't  exactly 
insane  now,  but  just  the  same  she  will  always 
have  a  crazy  head.    She  knew  she  was  a  sick  girl 


A  COMPULSION  NEUROSIS         351 

when  she  married,  but  you  were  an  easy  mark  and 
let  her  rope  you  in." 

Stella's  rage  upon  perusing  these  amiable  senti- 
ments should  have  found  adequate  expression  in 
her  having  torn  her  dothes  and  hair,  yelled^ 
screamed,  rolled  on  the  floor,  and  ornamented  with 
her  nails  the  faces  of  her  husband  and  his  offend- 
ing sister ;  still  all  this  by  no  means  removed  the 
memory  of  the  incident  from  her  mind  nor  served 
to  prevent  her  from  bearing  a  lasting  resentment. 
Indeed  whenever  she  thought  of  the  matter  she 
would  immediately  become  incoherent  from  anger 
and  excitement.  '^Boped  him  inl";  she  would 
cry.  ^ '  A  nice  remark  for  a  friend  to  make  I  The 
mean,  low,  false  thing  I  Gould  any  decent  per- 
son say  a  thing  like  thatt  There  isn't  a  more 
false  and  tricky  girl  in  the  world.  I'd  like  to 
scratch  out  her  eyes  and  wring  her  neck,"  etc. 

Again  applying  the  principle  of  interpretation 
already  described,  one  would  have  to  conclude  that 
Stella  thus  reproached  her  sister-in-law  because 
she  herself  felt  guilty  of  being  a  false  friend.  In 
just  what  respect  she  had  been  false  remains  to  be 
seen,  however.* 

The  fact  that  Stella  found  the  accusation,  ^^she 
roped  you  in,"  so  painful  has  to  be  explained  in 
another  way.  The  reason  this  remark  so  aroused 
her  anger  must  have  been,  I  concluded,  that  it  con- 
tained a  very  considerable  element  of  truth.  If 
the  accusation  had  been  entirely  unjust,  I  felt,  she 
would  not  have  minded  it  nearly  so  much.    ^^It's 

1  Page  423. 


352    MOEBID  FEAES  AND  COMPULSIONS 

only  the  truth  that  hurts. ' '  But,  having  come  to 
audi  a  condusion,  I  was  no  better  off  than  before, 
f or,  as  far  as  I  was  aware,  Stella  had  never  done 
anything  that  could  well  be  described  as  ^'roping 
in"  Barney.  To  be  sure,  she  married  him  with- 
out caring  particularly  for  him,  but,  even  so,  it 
was  Barney  who  had  been  the  aggressor,  and  if 
any  ^^roping  in''  had  occurred  he  himself  had 
done  it.  In  spite  of  these  facts,  I  could  not  reject 
my  original  conclusion  that  in  some  sense  Stella 
had  '^ roped  in"  Barney  and  that  she  felt  guilty 
about  it,  but  the  only  course  left  for  me  was  to 
wait  in  the  hope  that  in  the  course  of  the  analysis 
new  material  would  be  brought  out  to  confirm  my 
views. 

Let  me  now  sum  up  what  has  been  learned  in 
regard  to  Stella's  feeling  and  attitude  toward  her 
husband.  First,  the  conclusion  that  Stella  mar- 
ried Barney  caring  little  or  nothing  for  hin[i,  which 
was  reached  before  taking  up  the  analysis  proper, 
has  been  fairly  well  confirmed.  Second,  from  an- 
alyzing one  set  of  Stella's  reproaches  against  Bar- 
ney there  has  been  furnished  reason  to  "suppose 
that  some  unknown  economic  conditions  caused  her 
to  marry  him.  At  the  same  time,  this  was  hard  to 
understand,  since  she  had  another  suitor,  Leh- 
mann,  whom,  apparently,  she  preferred  to  Bar- 
ney, and  who  was  better  off  finandally.  Third, 
we  have  readied  the  conclusion  that  Stella  wished 
to  be  free  again  either  through  Barney's  death,  or, 
possibly,  through  divorce  or  separation.  Fourth,^ 
we  have  two  other  pieces  of  information  which 
are  as  yet  of  uncertain  significance;  viz.^  that 


A  COMPULSION  NEUROSIS         353 

somehow  or  other  Stella  felt  guilty  of  roping 
Barney  in,  and  that,  whatever  it  might  mean,  she 
felt  that  she  was  ^^too  strong  for  him." 

(c)  The  Assault  Obsession 

Let  us  now  leave  for  a  time  the  subject  of 
Stella's  relations  with  Barney  and  take  up  another 
matter  which  at  first  seems  to  have  no  connection 
with  the  first.  Stella  bad  been  coming  to  me  some 
considerable  time  when  one  day  she  said  suddenly, 
'*  Doctor,  the  Eishef  obsession  is  not  the  only  one 
I  ever  had.  Several  years  ago  I  had  another  that 
I  have  been  afraid  to  tell  to  you.'* 

The  complete  history  of  this  first  obsession  I 
was  a  long  time  in  learning.  I  will,  however,  give 
it  here  without  going  into  the  details  of  how  I 
acquired  my  information.  Stella,  when  about  sev- 
enteen and  a  half  years  of  age,  had  once  taken 
supper  at  the  house  of  a  friend  of  hers,  a  young 
married  woman  named  Mrs.  Denzer.  Mr.  Denzer 
was  not  present  at  this  meal,  but  considerably  later 
in  the  evening  he  came  in  accompanied  by  two 
other  young  men,  who  boarded  in  his  household. 
For  some  unknown  reason  Stella  began  to  have  a 
certain  fear  of  these  men,  although  in  her  previous 
acquaintance  with  them  nothing  had  occurred  to 
justify  such  an  emotion.  But,  in  consequence  of 
this  feeling,  she  soon  arose  and,  putting  on  her 
hat,  announced  that  it  was  time  for  her  to  go  home. 
But  Mrs.  Denzer  would  not  hear  of  her  departure 
^and  insisted  that  Stella  must  spend  the  night. 
This  made  Stella  more  anxious  than  ever,  and  she 
protested  with  no  little  vehemence  that  for  her  to 


354    MOBBID  FEABS  AND  COMPULSIONS 

remain  all  night  was  impossible.  Mrs.  Denzer 
was  deaf  to  these  protests,  and  finally  settled  the 
matter  by  locking  the  only  door  of  exit  and  put- 
ting the  key  in  her  pocket,  so  that  Stella  had  to 
stay  whether  she  liked  it  or  not.  By  this  time 
Stella's  anxiety  had  shaped  itself  into  a  definite 
fear,  viz.,  that  after  she  had  retired  for  the  night 
one  of  these  men  would  attempt  to  assault  her  in 
her  sleep.  That  such  a  fear  was  utterly  absurd 
she  was  quite  well  aware,  for  none  of  the  men 
had  ever  betrayed  the  slightest  inclination  to  do 
anything  improper  either  to  her  or,  as  far  as  she 
knew,  to  any  other  well-behaved  young  woman. 
But,  in  spite  of  this,  she  was  unable  to  drive  the 
fear  from  her  mind.  She  decided,  therefore,  that 
after  going  to  bed  she  would  try  to  remain  awake 
all  night,  while  as  an  additional  precaution  she 
took  her  underskirt  and  bound  it  over  her  genitals, 
so  that,  should  she  fall  asleep  in  spite  of  herself, 
any  evilly  intentioned  person  would  have  diffi- 
colty  in  carrying  out  his  purpose.  However  good 
her  intentions  may  have  been,  she  did  fall  asleep 
eventually,  and  when  she  awoke  an  hour  or  two 
later  she  found  herself  possessed  by  the  horrible 
fear  that  while  she  slept  the  dreaded  occurrence 
had  actually  come  to  pass,  namely,  that  one  of  the 
men — she  knew  not  which— had  assaulted  her 
while  she  was  unconscious.  After  a  hasty  self- 
examination  for  evidences  of  such  a  happening 
she  was  momentarily  relieved  to  find  that  the  band- 
age she  had  made  of  her  underskirt  was  undis- 
turbed and  that  such  signs  as  genital  soreness, 


A  COMPULSION  NEUEOSIS         355 

drops  of  blood,  or  any  of  the  similar  phenomena 
which  she  had  been  led  to  expect  were  accompani- 
ments of  the  first  coitus,  were  entirely  absent. 
The  relief  following  upon  this  examination  was 
short-lived,  however,  for  it  occurred  to  her  that 
while  she  slept  any  blood  stains  might  have  been 
removed  and  the  bandage  readjusted  or  that 
her  imaginary  seducer  might  have  known  of  some 
method  of  performing  the  act  without  leaving  any 
painful  results.  Thus,  her  fear  persisted,  and 
she  said  to  herself,  '^  Since  I  was  asleep,  I  have  no 
absolute  knowledge  or  proof  that  it  didn't  hap- 
pen." 

At  any  rate,  she  left  the  house  of  her  friend  as 
quickly  as  possible  and  in  a  most  distracted  condi- 
tion hurried  home.  Arriving  there,  she  threw  her- 
self upon  a  bed,  crying  and  screaming.  Her 
mother,  attracted  by  the  noise,  came  in,  and  Stella 
soon  told  her  what  she  feared  and  insisted  upon 
being  examined  then  'and  there  for  evidences  of 
defloration.  Her  mother  promptly  complied  with 
this  request  and  assured  Stella  that  there  was  abso- 
lutely nothing  the  matter  with  her  except  ^^Mus- 
hagahs  im  Kopf.''  ^  But  this  did  not  satisfy  the 
young  lady,  and  in  a  day  or  two  she  had  herself 
examined  by  a  doctor,  but  with  the  same  result. 
Her  fear  remained  unabated  in  spite  of  the  doc- 
tor's assurances.  In  the  next  few  weeks  she  went 
to  one  doctor  after  another,  receiving  from  each 
assurances  that  everything  was  as  it  should  be, 
but  without  gaining  any  relief  from  her  fear. 

1  CimzliMM  in  thft  bflftd. 


356    MOBBID  PEABS  AND  COMPULSIONS 

Why  these  assurances  did  not  assure  her  will 
later  become  clearer.  They  did  not  touch  the 
right  spot. 

All  this  time  she  was  extremely  anxious  to  ob- 
tain a  certificate  to  the  effect  that  she  was  a  vir- 
gin, but  she  hesitated  to  ask  for  it  for  fear  that 
the  doctors  would  suspect  her  of  ^^  something 
queer. "  At  last,  after  returning  home  from  hav- 
ing been  examined  by  a  woman  doctor,  who,  by  the 
way,  had  hurt  her  considerably,  Stella  found  a 
drop  or  two  of  blood  on  her  underskirt.  This  dis- 
covery greatly  excited  her,  for  she  felt  that  even 
if  up  to  this  time  she  had  been  wrong  in  fearing 
her  hymen  was  ruptured,  there  was  no  doubt  of  its 
being  ruptured  now,  as  the  result  of  the  doctor's 
examination.  Hence,  she  returned  to  this  physi- 
cian, demanding  a  certificate  which  should  state 
either  that  her  hymen  was  entirely  intact,  or  else 
that  it  had  been  ihiptured  accidentally  during  ex- 
amination. Such  a  certii^cate,  somewhat  am- 
biguously worded,  she  did  finally  receive. 

The  assault  obsession  lasted  without  abatement 
for  some  eight  or  nine  months,  but  then  it  gradu- 
€illy  cleared  up.  After  this  it  reappeared  oc- 
casionally even  up  to  the  time  the  ELishef  obses- 
sion began,  though  never  with  any  great  severity. 

Naturally  enough,  Stella  told  of  this  obsession 
to  very  few  people.  One  she  told  was  her  mother, 
who,  much  to  Stella's  real  or  assumed  dissatisfac- 
tion, told  it  to  her  father.  The  only  other  person 
to  whom  Stella  spoke  about  it  was  Bose,  the  same 
cousin  who  was  connected  with  the  Eashef  incident. 
To  Bose  she  did  not  speak  frankly,  however. 


A  COMPULSION  NEUKOSIS         357 

Bose  had  observed  that  Stella  seemed  to  have 
something  on  her  mind,  and  questioned  her  as  to 
the  nature  of  the  trouble.  Stella  at  once  began 
to  cry,  saying,  ^^Bose,  I  am  afraid  something  aw- 
ful has  happened  to  me — something  that  has  made 
my  body  different  than  it  was.  If  what  I  fear  is 
really  true,  it  would  be  wrong  for  me  to  get  mar- 
ried, and  I  ought  not  to  do  it.*' 

I  should,  perhaps,  state  that  the  question  of 
marriage  had  come  up  at  this  time,  for  Stella  had 
a  suitor,  a  young  man  in  good  circumstances,  who 
was  highly  favored  by  her  parents,  although  not, 
if  we  are  to  believe  her,  by  Stella  herself.  But, 
at  any  rate,  his  attentions  lasted  only  a  short  time, 
and  he  soon  passed  out  of  her  life. 

Now,  toward  understanding  the  motivation  of 
this  obsession  the  following  matters  can  be  pro- 
duced. First,  it  is  to  be  noted  that  the  obsession 
came  on  only  a  short  time  after  the  incident  I  have 
described  and  which  put  an  end  to  her  father's 
masturbatic  visits  to  Stella's  bedside.  One  might 
suppose,  then,  that  her  libido,  thus  cut  off  from 
its  earlier  outlet,  had  found  a  new  channel  of  ex- 
pression in  the  shape  of  the  obsession.  Inciden- 
tally, Stella,  ill  with  an  obsession,  was  in  a  position 
(of  which,  I  may  add,  she  took  every  advantage) 
to  demand  more  in  the  way  of  sympathy  and  at- 
tention from  her  father  than  she  would  have  been 
able  to  secure  under  ordinary  circumstances. 
Thus,  she  received  a  sort  of  compensation  for  the 
loss  of  the  more  physical  form  of  gratification 
which  was  no  longer  forthcoming.  Furthermore, 
the  illness,  which  gave  her  father  an  enormous 


358    MOEBID  FEABS  AND  COMPULSIONS 

amount  of  trouble  and  distress,  served  as  a 
weapon  with  which  she  revenged  herself  upon  him 
for  taking  her  too  readily  at  her  word  and  stop- 
ping his  visits.^  It  also  seems  probable  that  the 
self-reproach  connected  with  the  idea  of  assault 
represented  a  displacement  of  the  guilt  which  she 
had  felt  for  allowing  her  father  to  touch  her  and 
for  wishing  he  would  continue  to  do  so. 

But  there  is  also  reason  to  suppose  the  obses- 
sion represented  a  direct  fulfillment  of  certain 
wishes  that  Stella  had  previously  entertained. 
For  both  in  day  dreams  and  in  night  dreams  she 
had  frequently  imagined  herself  to  be  the  subject 
of  an  assault,  and  she  was  perfectly  conscious  of 
having  had  a  wish  that  through  no  fault  of  hers 
such  a  thing  might  happen  to  her.  For,  as  she 
explained,  though  she  would  never  part  with  her 
chastity  voluntarily,  yet,  if  in  spite  of  her  best  en- 
deavors to  the  contrary  it  was  taken  away  from 
her  by  force,  the  situation  would  then  be  quite  dif- 
ferent. Her  virginity  once  lost,  the  chief  motive 
for  remaining  in  the  paths  of  virtue  would  have 
been  done  away  with,  while,  on  the  other  hand,  she 
would  feel  almost  justified  in  compensating  her- 
self for  the  catastrophe  by  indulging  in  inter- 
course, a  form  of  pleasure  which,  as  she  was  of  a 
very  erotic  nature,  she  was  extremely  desirous  of 
having. 

iTiM  relation  between  the  obeeeslon  end  a  wish  on  Stdla'e  part 
to  be  maetorbated  by  her  father  will  be  referred  to  again  in  con- 
nection with  the  analysis  of  the  Kishef  obsession,  where  at  the 
■ame  time  the  significance  of  Stella's  repeated  visits  to  doetors 
will  be  given  further  consideration. 


A  COMPULSION  NEUROSIS         359 

That  some  erotic  wishes  were  in  her  mind  the 
night  the  obsession  came  on  is  not  to  be  doubted, 
for  she  distinctly  remembers  that  all  the  evening 
she  was  at  Mrs.  Denzer's  she  had  been  occupied 
in  comparing,  with  a  certain  envy,  her  friend's 
situation  with  her  own.  Thus,  she  not  only  re- 
flected on  the  pleasures  that  were  accessible  to 
her  friend  upon  retiring,  but  also  indulged  in  cer- 
tain erotic  fancies  in  which  she  occupied  her 
friend's  place  in  the  domestic  relation,  or  passed 
through  similar  experiences  with  a  husband  of  her 
own.  It  seems  highly  probable,  then,  that  Stella's 
erotic  wishes  formed  one  of  the  determinants  of 
the  obsession ;  that  is,  as  she  herself  summed  up 
the  situation,  '^What  I  imagined  that  evening  at 
first  for  pleasure  soon  became  a  fear  and  finally 
an  obsession." 

But  the  obsession  probably  corresponded  to 
the  imaginary  fulfillment  of  still  another  wish, 
namely,  a  wish  for  pregnancy.  I  have  already 
stated  that  Stella's  menstruation  had  always  been 
irregular.  During  the  period  of  her  father's  noc- 
turnal ministrations,  and  on  such  occasions  as  she 
did  not  become  unwell  when  she  expected,  she  was 
always  terrified  by  the  thought  that  she  was  preg- 
nant by  him.  (It  should  be  added  that  this  fear, 
which,  of  course,  can  be  readily  translated  as  the 
fulfillment  of  a  wish,  is  not  as  absurd  as  it  seems, 
for  her  knowledge  of  how  impregnation  is  effected 
was  at  that  time  very  vague.)  A  wish  to  be  preg- 
nant by  her  father  as  well  as  by  others  had  even 
entered  her  consciousness  at  times,  for  she  well 
remembered  that  she  had  frequently  indulged  in 


360    MOBBID  FEABS  AND  COMPULSIONS 

day  phantasies  having  such  a  content.  That  the 
wish  to  be  pregnant  was  uppermost  in  Stella's 
mind  on  that  particolar  night  can  hardly  be 
doubted,  for  Mrs.  Denzer  had  two  children  the 
possession  of  which  Stella  greatly  envied  her  and 
which  she  at  times  took  pleasure  in  imagining  were 
her  own.  An  additional  fact  which  I  learned 
much  later  was  that  Stella  was  expecting  to  be 
unwell  on  the  night  the  obsession  appeared.  But, 
since  she  had  this  expectation  on  the  fateful  night, 
her  bandaging  herself  on  retiring  was  not  so  en- 
tirely without  reasonable  motivation  as  it  at  first 
seemed.  This  act  was  in  jmrt  prompted  by  the 
reflection  that  the  flow  was  due  to  appear,  and 
when  on  the  morrow  it  had  not  done  so,  she  had 
a  sort  of  confirmation  of  the  idea  she  had  been 
assaulted;  that  is,  she  found  herself  displaying 
one  of  the  symptoms  of  pregnancy.^ 

To  sum  up,  then,  our  present  knowledge  of  the 
obsession,  it  formed  an  imaginary  fulfillment  to 
two  wishes,  one  to  be  assaulted  and  the  other  to  be 
pregnant  and  to  have  children.  The  wish  to  be 
assaulted,  as  Stella  pointed  out,  was  not  so  mudi  a 
desire  for  the  act  itself  as  a  wish  that  through  no 
fault  of  hers  she  would  be  placed  in  such  a  posi- 
tion that  she  would  have  nothing  further  to  lose 
by  illicit  sexual  relations.  The  obsession  also 
served  as  a  means  of  obtaining  compensation  for 
the  loss  of  her  father's  sexual  attentions  and  for 
denying  herself  the  pleasure  of  marrying  the 
young  man  who  was  then  courting  her.    Just  why 

1  An  additional  fact  in  regard  to  the  delay  of  this  period  will 
be  produced  later.    Pag«  387. 


A  COMPULSION  NEUROSIS         361 

she  did  not  take  advantage  of  this  opportunity  to 
gratify  her  desires  in  a  normal  way  by  marrying 
him  ykn  become  clearer  as  we  go  on  with  the  an- 
alysis. 

But,  before  temporarily  leaving  the  subject  of 
this  obsession,  as  we  will  have  to  do  now,  let  me  ex- 
press a  hope  that  no  one  will  be  hasty  in  judging 
the  interpretation  offered  as  fanciful  and  absurd, 
for  at  a  later  stage  in  the  report  of  this  analysis, 
material  is  to  be  produced,  which,  to  my  mind  at 
least,  forms  most  adequate  and  surprising  con- 
firmation. 

(d)  The  Main  Sources  of  Resistcmce  against 

Marriage 

We  shall  now  again  occupy  ourselves  with  the 
theme  of  Stella's  relations  with  her  husband. 
The  analysis  had  been  in  progress,  if  I  remember 
correctly,  between  two  and  three  months  when  a 
very  serious  occurrence  took  place.  Barney,  who, 
without  my  knowledge,  had  for  some  little  time 
complained  of  a  cough  and  a  tendency  to  become 
easily  tired,  finally  presented  himself  at  a  public 
clinic,  where,  after  being  examined,  he  received  the 
depressing  intelligence  that  he  suffered  from  pul- 
monary tuberculosis.  This  diagnosis  was  soon 
confirmed  at  other  clinics,  and,  consequently,  prep- 
arations were  immediately  made  for  sending  him 
to  a  sanitarium  in  the  country. 

When  Stella,  who  for  a  few  days  had  been  so 
fully  occupied  that  she  did  not  present  herself  at 
the  dispensary,  resumed  her  visits  and  communi- 


362    MOBBID  FEABS  AND  COMPULSIONS 

cated  to  me  this  distressing  information  I  was 
surprised  to  observe  that  there  apparently  was  not 
the  slightest  change  in  her  mental  condition,  either 
for  the  worse  or  for  the  better.  One  would  nat- 
urally expect  a  crisis  of  this  sort  to  have  produced 
some  exacerbation  of  her  symptoms  or,  possibly, 
the  reverse,  and  the  fact  that  nothing  of  the  kind 
occurred  arrested  my  attention  immediately,  al- 
though at  the  time  I  could  think  of  no  way  of  ex- 
plaining it.  I  did  arrive  at  an  explanation,  later, 
however,  upon  the  basis  of  the  facts  whidi  I  shall 
now  present. 

The  first  fact  which  upon  analysis  seemed  to 
have  a  bearing  on  the  question  in  hand  was  this. 
Stella  had  once  told  me  that  some  time  in  the  first 
three  or  four  months  of  her  coming  to  the  clinic 
she  had  conceived  the  idea  that  I  was  an  Irishman, 
and  that  this  thought  had  caused  her  to  feel  a  cer- 
tain aversion  or  resistance  toward  me.  That  she 
did  feel  so  surprised  her  considerably,  for  she  had 
never  before  been  conscious  of  any  prejudice 
against  the  Irish ;  and,  in  addition,  her  reason  told 
her  that,  despite  her  peculiar  feeling  to  the  con- 
trary, I  was  not  Irish.  I  learned  eventually  that 
she  first  felt  this  aversion  toward  me  one  morn- 
ing when  she  noticed  a  spot  of  blood  on  my  lip, 
where  I  had  cut  myself  in  shaving.  We  shall  de- 
fer for  a  moment  the  analysis  of  this  peculiar  idea 
in  order  to  take  up  the  presentation  of  another. 

One  day,  some  weeks  before  the  matter  of  her 
husband's  tuberculosis  came  up,  Stella  inadver- 
tently addressed  me  as  Mr.  Frink.  This  particu- 
larly impressed  me  because  in  our  acquaintance 


A  COMPXJLSION  NEUEOSIS         363 

of  over  a  year  she  had  not  done  so  to  the  best  of 
my  recollection.  I  inunediately  asked  her  to  ex- 
plain her  mistake,  and  she  replied  that  she  could 
not,  adding,  however,  that  there  came  to  her 
mind  the  thought  of  a  certain  Mr.  Schermer. 
Asked  for  some  information  about  this  man,  Stella 
told  me  that  she  had  made  his  acquaintance  a  few 
days  before  under  the  following  circumstances. 
A  certain  relative  of  her  husband  had  had  the  mis- 
fortune to  be  arrested  for  the  violation  of  some 
sanitary  law  and  at  the  moment  of  our  conversa- 
tion was  languishing  in  jaiL  Stella  had  been 
detailed  to  interview  Mr.  Schermer,  the  head  of  a 
certain  lodge  to  which  the  incarcerated  one  be- 
longed, in  the  hope  of  invoking  some  financial  and 
political  aid  in  that  gentleman's  behalf.  Mr. 
Schermer  had  listened  to  Stella's  representations 
with  many  expressions  of  sympathy,  but  it  soon 
became  apparent  that  his  position  in  the  matter 
could  be  summed  up  in  the  words,  ^'I  am  sorry,  but 
/  canH  do  anything/* 

Having  concluded  the  description  of  her  visit 
to  Mr.  Schermer,  Stella  paused.  Urged  to  give 
further  associations,  she  stated  that  there  came 
to  her  mind  a  certain  Mr.  Frank,  but  immediately 
explained  that  this  association  was  of  no  conse- 
quence, for  she  had  thought  of  him  merely  because 
his  name  was  so  similar  to  mine. 

We  are  accustomed  to  find  that  when  two  idea 
groups  are  connected  by  a  superficial  association 
—one  of  soxmd,  for  instance,  as  in  this  case — they 
are  also  connected  by  some  deeper,  more  impor- 
tant, but  concealed  association.    With  this  in  mind, 


364    MORBID  FEAES  AND  COMPULSIONS 

I  asked  Stella  to  tell  me  what  occurred  to  her 
abont  Mr.  Frank.  And,  since  her  association  con- 
cerning Mr.  Schermer  had  contained  the  idea,  '^he 
couldn't  do  anything,''  I  was  not  surprised  when 
Stella  told  me  that  there  had  been  confided  to  her 

by  Mrs.  Frank  the  information  that  Mr.  F was 

impotent.  My  explanation  of  Stella's  slip  of 
speech  was,  then,  that  she  had  identified  me  with 
some  other  individual  who  in  some  undiscovered 
particular  resembled  Mr.  Frank  in  being  sexually 
weak  and  Mr.  Schermer  who,  in  another  sense, 
**couldnt  do  anything." 

Now,  I  happened  to  know  that,  at  the  time,  Stella 
was  identifying  me  with  both  Max  and  Barney, 
for  she  frequently  took  occasion  to  remark  that  in 
our  looks  and  manners  she  perceived  many  points 
of  resemblance.  But,  feeling  that  there  was  some 
basis  of  identification  deeper  than  mere  similarity 
in  appearance  and  manners,  I  asked  of  Stella, 
"Did  you  think  Max  was  sexually  weak!" 

"I  did,"  she  replied,  after  a  moment's  hesita- 
tion. 

**And  do  you  think  me  sot"  I  continued. 
«  *  *  I  hope  you  will  excuse  me, ' '  she  replied,  laugh- 
ing, **but  I  think  you  are  weak,  too." 

Upon  considering  this  information,  however, 
it  at  first  did  not  seem  very  illuminating,  after  all. 
I  had  supposed  that  Stella  had  in  some  way  iden- 
tified Max,  Barney,  and  me ;  that  is,  that  there  was 
some  unknown  common  factor  which  she  ascribed 
to  us  all.  The  associations  just  recorded  seemed 
to  indicate  that  this  was  sexual  weakness,  and  she 
had  already  told  me  that  Barney  suffered  from 


A  COMPXJLSION  NEUROSIS         365 

prematnre  ejacnlation.  Yet  the  view  that  she  as- 
cribed to  all  three  of  uts  some  sexnal  weakness  was 
difBcnlt  to  accept,  for  by  what  conceivable  process 
of  reasoning  conld  she  have  formed  any  opinion 
in  regard  to  the  sexual  power  of  Max  and  myself  T 
Fnrthermore,  something  in  Stella 's  tone  made  me 
suspicious  that  the  phrase,  ** sexually  weak,''  did 
not  comprehend  all  she  had  in  mind,  but  merely 
served  as  a  cover  for  something  else  she  was  not 
ready  to  betray.  The  phrase  must  have  had  some 
significance,  however,  for  it  had  come  up  in  con- 
nection with  the  dream  already  related  when  it 
was  associated  with  the  idea  l^at  she  was  '^too 
strong''  for  her  husband. 

It  occurred  to  me  that  sterility  might  be  the  con- 
cealed common  factor,  for  Stella  supposed  her 
husband  to  be  sterile  and  knew  that  I  had  no  chil- 
dren. But  here  again  arose  the  same  difficulty. 
Though  she  might  suppose  two  members  of  the 
triad  to  be  sterile,  how  could  she  have  formed  any 
opinion  about  Max  in  this  particular? 

I  had,  then,  either  to  abandon  my  hypothesis 
that  some  reproductive  weakness  was,  in  her 
opinion,  common  to  the  three  of  us,  or  else  con- 
clude that  she  had  in  mind  some  other  sort  of  de- 
ficiency, possibly  related  to  sex,  and  that  it  was 
this  that  she  supposed  to  be  common  to  Barney, 
Max,  and  me.  This  latter  conclusion  seemed  to 
me  the  most  acceptable,  for  there  had  been  a  hint 
of  this  same  elusive  deficiency,  whatever  it  might 
be,  in  the  results  of  the  analysis  of  the  dream. 

There  soon  came  to  light  another  transference 
phenomenon,  which  proved  to  be  the  key  to  a  solu- 


366    MOEBID  FEAES  AND  COMPULSIONS 

tion  of  the  mystery.  Stella  began  to  manifest  a 
considerable  anxiety  abont  my  health.  She  would 
tell  me  I  smoked  too  much,  that  I  should  spend 
more  time  in  the  open  air,  and  that  I  must  be  care- 
ful abont  my  diet.  These  remarks  usually  ended 
in  her  laughing  at  herself  and  saying  that,  since 
I  was  a  doctor,  I  must  think  her  very  presimiptn- 
ous  in  advising  me  on  matters  of  health.  But,  in 
spite  of  this,  as  likely  as  not  at  the  next  visit  she 
would  repeat  the  whole  performance. 

This  anxiety  about  my  health  might  very  well 
indicate  that  she  suspected  or  feared  that  I  had 
some  malady  of  a  general  nature  and  not  prima- 
rialy  sexuaL  But  some  essentially  nonsexual  ill- 
ness might  have,  secondarily,  an  injurious  effect 
upon  one's  potence  and  reproductive  ability. 
Thus  the  hints  that  had  come  up  to  the  effect  that 
Stella  thought  Barney,  Max,  and  me  deficient  in 
the  sexual  sphere  might  really  have  had  an  origin 
in  her  thinking  that  all  three  of  us  suffered  from 
some  nonsexual  physical  malady.  Upon  analyz- 
ing Stella's  peculiar  notion  that  I  was  an  Irish- 
man, not  only  is  the  hypothesis  confirmed  but  the 
analysis  also  discloses  what  physical  illness  she 
supposed  we  had. 

It  wUl  be  remembered  that  her  thought  that  I 
was  Irish  came  on  when  she  saw  a  spot  of  blood 
upon  my  lip.  Blood  upon  the  lips  might  well  sug- 
gest hemoptysis,  and,  hence,  tuberculosis.  Now, 
Stella  was  accustomed  to  refer  to  tuberculosis  as 
the  **Con"  and  to  a  person  suffering  from  that 
disease  as  a  ^ '  Conner. ' '  But  Connor  is  a  familiar 
Irish  name.    I  am  thin  and  quite  subject  to  colds ; 


A  COMPXJLSION  NEUROSIS         367 

hence,  when  Stella  saw  a  drop  of  blood  upon  my 
lip  there  conld  easily  have  started  in  her  mind  a 
train  of  thought  having  as  its  theme  a  question  as 
to  whether  I  were  not  a  consumptive.  But,  if  for 
any  reason  Stella  had  a  resistance  against  the 
theme  of  tuberculosis,  what  more  natural  than 
that,  if  she  began  to  suspect  that  I  was  a '  ^  Conner ' ' 
in  the  sense  of  being  consumptive  and  to  feel  a 
certain  aversion  to  me  on  that  account,  this  affect 
of  aversion  should  be  displaced  by  way  of  the 
other  mei.aing  of  the  word  (Connor)  and  so  ap- 
pear in  her  consciousness  attached  to  the  thought 
that  I  was  an  Irishman  f  In  this  way  it  becomes 
clear  how  Stella  could  feel  a  repugnance  to  me  as 
being  an  Irishman  and  yet  at  the  same  time  be 
convinced  that  I  was  not  Irish. 

This  interpretation,  I  confess,  might  easily  be 
regarded  as  rather  fanciful  were  it  not  for  the  fact 
that  the  thought  that  I  was  Irish  had  such  a  sig- 
nificant starting  point,  viz.,  the  spot  of  blood  upon 
my  lip.  This,  it  seemed  to  me,  placed  my  inter- 
pretation practically  beyond  question  and  justified 
my  forming  the  hypothesis  that  the  defect  which 
Stella  had  supposed  to  be  common  to  Barney,  Max 
and  me  was,  in  fact,  pulmonary  tuberculosis. 

Let  us  now  see  how  this  hypothesis  fits  the  facts 
at  our  command.  The  supposition  that  Stella 
thought — or  perhaps  I  should  say  knew — ^that  Max 
bad  tuberculosis  explains,  in  part  at  least,  several 
important  things  which  at  first  were  most  mys- 
terious. 

The  first  one  is  the  fact  that,  although  Max  ap- 
peared to  be  in  love  with  Stella,  he  made  no  defin- 


368    MOBBID  FEABS  AND  COMPULSIONS 

ite  advances  and  did  not  ask  her  to  marry  him. 
This  attitude  was  quite  natural  if  he  really  had 
tuberculosis,  for  under  such  circumstances,  no 
matter  how  much  he  cared  for  the  young  lady,  he 
might  well  have  hesitated  either  to  make  love  to 
her  or  to  ask  for  her  hand. 

Second,  Stella's  remark  that  she  knew  Max  was 
not  ^^a  marrying  man,"  which  I  had  never  been 
able  to  get  her  to  explain  satisfactorily,  is  now 
easy  to  xmderstand.  If  she  thought  he  had  tuber- 
culosis she  would  suppose  that  he  would  on  ac- 
count of  it  not  intend  to  marry. 

Third,  it  no  longer  seems  utterly  incomprehen- 
sible that  Bose's  remark  concerning  Max,  '^ he'll 
be  weak  and  sickly  all  the  rest  of  his  life,"  should 
have  had  sudi  a  profound  effect  upon  Stella  and 
have  formed  the  starting  point  of  an  obsession. 
If  Stella  believed  that  Max  had  consumption,  this 
remark,  coming  as  it  did  from  some  one  who  had 
never  even  seen  him,  might  well  have  startled 
Stella  and  filled  her  with  a  superstitious  dread. 

Fourth,  the  fact  which  at  first  seemed  so  singu- 
lar, viz.,  that  Stella  seemed  to  believe  in  Bose's 
prophecy  that  Max  would  be  sickly  all  his  life,  no 
longer  appears  strange.  If  Stella  believed  Max 
had  tuberculosis,  she  had  good  reason  for  accept- 
ing Bose's  prediction  that  he  would  never  be 
strong. 

Fifth,  the  doubt  in  Stella's  mind  as -to  the  advis- 
ability of  marrying  Max,  which  we  concluded  ex- 
isted, without  knowing  its  exact  cause,  we  can  now 
explain.  Presumably  it  was  her  belief  that  Max 
was  tubercular  that  was  the  source  of  the  conflict 


A  COMPULSION  NETJBOSIS         369 

which  resnlted  in  her  wishing  that  if  she  married 
him  his  life  would  be  short. 

Sixth,  the  idea  that  Stella  was  'Hoc  strong" 
for  Barney,  which  was  met  with  in  analyzing  the 
dream  already  recorded,  and  which,  although 
Stella  said  the  phrase  had  a  sexual  meaning,  I 
thought  represented  some  other  sort  of  deficiency, 
can  now  be  explained.  The  deficiency  was  tuber- 
culosis, and  Stella  felt  that  she  was  too  strong  to 
be  married  to  so  weak  a  man. 

Seventh,  assuming  that  the  idea  of  deficiency 
met  with  in  analyzing  the  dream  really  referred 
to  Barney's  being  tubercular,  it  is  possible  to  ex- 
plain why  Stella  showed  no  particular  reaction 
and  experienced  no  change  in  her  symptoms  when 
Barney  went  to  the  clinic  and  the  diagnosis  of 
phthisis  was  made.  That  is,  the  dream  occurred 
only  a  short  time  after  I  began  the  analysis  of  her 
case  and  if,  as  it  seems,  the  weakness  on  Barney's 
part,  at  which  the  analysis  of  the  dream  hinted, 
was  really  tuberculosis,  it  is  clear  that  Stella  sus- 
pected Barney  had  this  disease  when  she  first  came 
to  me  and  long  before  he  was  examined  by  a  doc- 
tor. This  explains  why  the  report  of  the  doctor's 
findings  failed  to  affect  her — she  was  entirely  pre- 
pared for  it ;  the  fact  that  her  husband  had  tuber- 
culosis was  to  her  an  old  story,  and  the  doctor's 
assertion  of  what  she  already  knew  of  course  pro- 
duced no  reaction. 

It  is  clear,  th^n,  that  the  hypothesis  that  the 
weakness  or  defect  which  Stella  apparently  sup- 
posed to  be  common  to  Max,  Barney,  and  me,  was 
in  reality  tuberculosis,  not  only  is  perfectly  bar- 


370    MOEBID  FEARS  AND  COMPULSIONS 

monious  with  the  facts  that  have  been  brought  out, 
bnt  it  enables  us  to  explain  very  readily  many 
previously  bafiSing  things — ^things  which,  it  seems 
to  me,  could  be  explained  by  no  other  hypothesis. 
For  these  reasons  I  felt  pei^ectly  justified  in  look- 
ing on  it  not  as  a  mere  hypothesis  but  as  an  expo- 
sition of  actual  f act.^ 

I  therefore  began  to  lay  before  Stella  the  ex- 
planations just  set  forth,  with  expectation  that 
she  would  confirm  me  in  every  point.  But  she 
did  nothing  of  the  kind.  I  asked  her  if  she  had 
ever  thought  me  tubercular,  and  she  admitted  that 
such  an  idea  had  once  or  twice  crossed  her  mind. 
She  also  admitted  that  shortly  before  Barney  was 
examined  she  had  wondered  if  perhaps  he  had  not 
some  lung  trouble,  but  in  regard  to  Max  she  would 
make  no  such  admission,  saying,  ^^Do  you  think  I 
would  have  been  such  a  fool  as  to  want  to  marry 
him  if  I  had  suspected  that  he  was  sickf ' '  To  this 
I  replied  by  calling  her  attention  to  the  fact  that 
by  her  own  admission  she  had  wanted  to  marry 
Max  in  spite  of  the  fact  that  she  supposed  he 
would  be  *  *  weak  and  sickly  all  his  life. ' '  But  this, 
instead  of  making  her  agree  with  me,  had  just  the 
opposite  effect.  She  at  once  retracted  her  former 
admissions,  disagreed  with  everything  of  any  sort 
that  I  undertook  to  tell  her,  and  so  clearly  mani- 
fested an  inclination  to  combat  at  all  costs  my  at- 
tempts to  explain  her  neurosis  that  I  stopped  with- 

1  My  belief  was  that  Stella  in  some  way  knew  tliat  Max  and 
Barney  had  tuberculosis — ^in  the  latter  case  independently  of  the 
doctox^s  report*— and  that  because  I  am  thin  and  have  a  smoker's 
cough  she  had  transferred  to  me  the  idea  that  I  too  suffered  from 
the  same  malady. 


A  COMPULSION  NEUROSIS         371 

out  having  told  her  of  all  the  condnsions  that  have 
been  set  forth. 

But  though  Stella  had  not  confirmed  me  in 
words,  I  looked  upon  her  quite  obviously  unreas- 
onable opposition  as  an  involuntary  confirmation. 
That  is,  I  thought  that  she  knew  me  to  be  right, 
and  was,  in  fact,  surprised  to  find  how  much  I  had 
been  able  to  learn  of  what  she  wished  to  conceal. 
Her  vigorous  opposition  was  then  determined,  I 
believed,  by  the  fact  that  there  were  other  things 
she  did  not  wish  to  disclose,  for  she  now  felt  she 
could  not  keep  them  from  me  and  concluded  that 
her  greatest  safety  lay  in  disputing  every  conclu- 
sion I  made  and  making  no  admission  whatsoever. 

I  explained  this  to  her  without  materially  de- 
creasing her  resistance  however,  and  there  fol- 
lowed a  very  long  period  in  which  I  made  prac- 
tically no  progress  in  the  analysis  of  her  obses- 
sions. She  had  no  dreams,  would  give  but  few 
associations,  '^nothing  came  to  her  mind,"  and 
she  was  late  for  every  sitting.  The  only  themes 
tihiat  she  was  always  ready  to  talk  about  were  the 
hopelessness  of  her  case,  the  futility  of  psychoan- 
alysis, and  the  impossibility  of  her  being  able  to 
respect  me  either  as  a  physician  or  a  man  after  I 
had  made  against  her  such  stupid  accusations  and 
persisted  with  them  in  such  a  stubborn  and  un- 
reasonable manner. 

All  this  I  could  interpret  as  an  effort  to  avoid 
facing  the  perception  that  it  was  very  largely  her 
own  fault  that  we  were  not  making  better  prog- 
ress— that  is,  she  endeavored  to  believe  me  and 
my  method  of  treatment  at  fault  as  a  defense 


372    MOEBID  FEAES  AND  COMPULSIONS 

against  the  feeling  that  she  herself  was  to  blame  in 
not  doing  her  part  by  disclosing  all  she  could. 

I  was  soon  convinced  that  there  was  something 
in  her  life  that  was  so  painful  to  her  that  she 
would  almost  rather  remain  sick  than  have  it 
known,  and  on  this  account  I  would  have  given  up 
the  treatment  had  it  not  been  for  two  reasons: 
first,  the  hope  that  in  spite  of  her  resistance  I 
would  some  time  find  out  ^at  she  was  concealing 
and  so  gratify  my  very  considerable  curiosity  as 
to  what  made  her  sick ;  and,  second,  that  a  set  of 
anxiety  hysteria  symptoms  came  into  prominence 
at  this  time  and  that  I  had  no  great  difficulty  in 
analyzing  them.  These  kept  up  my  interest  and 
prevented  me  from  giving  up  the  work.  I  will 
not  refer  to  these  symptoms  here,  for  they  repre- 
sent a  sort  of  digression  from  the  theme  of  the 
main  obsession  which  is  already  long  enough. 

The  long  period  of  intense  resistance  was  finally 
brought  to  an  end  in  the  following  way. 

Stella  came  one  day  and  began  immediately: 
*  *  I  've  been  awfully  sick,  Doctor.  Last  night  I  had 
a  terrible  attack  of  fear — ^the  worst  I  ever  had,  I 
thinf 

**What  were  you  afraid  of  f  I  asked. 

**0f  the  fortune  teller,  of  course,''  she  replied; 
"I  thought  surely  I  was  going  insane  right  away. 
I  don't  see  how  my  mind  can  stand  sudi  terrible 
fear." 

She  went  on  with  her  usual  complaints,  "111 
never  get  well,"  **I'm  lost,"  **I  have  no  future," 
etc.,  but  I  interrupted  her  by  asking:  ** Don't  you 


A  COMPXJLSION  NEUROSIS         373 

know  what  made  you  afraid  t  What  happened  to 
bring  on  the  attack?" 

"That  I'll  nev — ^nothing  happened — ^I  don't 
know  what  brought  on  the  attack, ' '  she  replied. 

But  she  did  not  interrupt  herself  soon  enough  to 
prevent  my  realizing  that  what  she  had  started  to 
eay  was,  *  *  That  I  '11  never  tell  you  I ' ' 

I  had  already  become  convinced  that  there  was 
something  of  importance  in  Stella's  life  that  she 
was  concealing  from  me.  I  now  had  confirma- 
tion of  this  belief,  for  it  seemed  plain  that  Stella 
knew  very  well  what  had  occasioned  the  severe  at- 
tack she  spoke  of.  I  therefore  said  to  her  that  I 
was  sure  she  could  explain  why  this  attack  oc- 
curred, but  she  insisted  that  this  was  not  so  and 
that  there  was  nothing  she  could  tell  me.  I  re- 
plied that  I  could  not  believe  her,  and  also  said 
that,  since  it  seemed  to  me  that  she  was  intention- 
ally concealing  something  important,  I  was  unwill- 
ing to  exert  myself  any  longer  unless  she  would 
do  her  part — ^in  short,  unless  she  told  me  the  cause 
at  once  I  would  give  up  the  treatment,  for  I  felt 
that  as  long  as  it  was  concealed  my  efforts  would 
do  her  no  particular  good,  and  that  for  me  to  con- 
tinue would  be  simply  a  waste  of  thne.  * 

She  protested  that  I  was  very  unjust,  that  she 
was  concealing  nothing,  and  ended  by  saying, 
"How  can  you  think  there  is  anything  I  would 

1  Although  it  had  some  results  in  this  case,  the  use  of  threats 
is  not  a  technical  procedure  that  can  be  recommended.  The  phy- 
sician should  try  to  understand  the  patient's  resistances  against 
disclosing  information  and  oTercome  them  by  explaining  them, 
rather  than,  so  to  speak,  by  using  force. 


374    MOBBID  FEABS  AND  COMPULSIONS 

keep  back  after  all  the  embarrassing  things  I  have 
told  youf  " 

I  replied  that  I  was  satisfied  I  was  right,  and 
that  at  any  rate,  right  or  wrong,  I  was  no  longer 
willing  to  treat  her  unless  the  important  piece  of 
information  I  expected  was  immediately  forth- 
coming.   She  knew  that  I  meant  what  I  said. 

At  this  point  I  was  called  ont  of  the  room  for  a 
few  minutes.  When  I  came  back  she  said,  ''Well, 
doctor,  IVe  been  thinking  it  over  and  I've  made 
up  my  mind.  I  know  I  shouldn't  take  np  your 
time  unless  I  let  you  know  everything.  At  last 
I'm  going  to  tell  you  my  secret." 

**Well,"  I  ask^,  **what  is  your  secret?" 

**Con,"  she  replied  briefly;  ''I've  had  tubercu- 
losis.   I've  been  in  two  different  sanitariums." 

Then  followed  a  story  which  gave  an  entirely 
new  insight  into  Stella's  psychic  conflicts  and  soon 
proved  to  be  the  key  to  the  solving  of  many  of 
the  mysteries  of  her  neurosis. 

Stella's  tuberculosis  began  when  she  was  thir- 
teen and  a  half  years  old,  manifesting  itself  by 
cough,  marked  loss  of  weight,  and  severe  and  re- 
peated hemorrhages.  ^ 

The  diagnosis  was  made  by  several  private  phy- 
sicians and  also  at  the  Broadway  Clinic,  from 
where  after  a  little  delay  she  was  sent  to  a  sani- 
tarium in  the  country.  There  she  remained  for 
about  five  months,  improving  considerably,  but 
finally  she  ran  away  and  returned  to  New  York 

1  It  WM  on  aeooimt  of  her  hmg  trouble  thftt  Stella  liad  to  leave 
mIiooI  at  an  early  age  rather  than,  ae  she  stated  at  tint,  that  her 
mother  "needed  her  to  help  with  the  house  work."    Plege  315. 


A  COMPULSION  NEXJBOSIS         375 

because  she  was  ''so  homesick/'  After  remain- 
ing in  New  York  for  a  few  months  her  symptoms 
returned  to  such  an  alarming  degree  that  she  again 
applied  at  a  dispensary  and  was  sent  to  a  second 
sanitariunu  In  this  place,  which  we  may  call  Oak- 
wood,  she  remained  for  several  months  and  im- 
proved a  great  deal.  But  she  was  again  overcome 
with  homesickness  and  finally  left  the  institution 
in  spite  of  the  fact  that  the  doctors  advised  her  to 
the  contrary.  Having  returned  home,  she  con- 
tinued to  improve,  so  that  before  long  she  was  en- 
tirely free  from  symptoms,  and  at  sixteen  years 
of  age  she  was  able  to  begin  work  in  the  store, 
apparently  in  the  best  of  health.  Unfortunately, 
this  was  not  the  end  of  her  trouble.  Later  she 
suffered  two  distinct  relapses,  both  of  which  as 
will  shortly  be  seen,  gave  rise  to  most  important 
problems  in  her  life  and  played  a  highly  signifi- 
cant role  in  the  development  of  her  obsessions. 

The  history  of  her  tuberculosis  is  what  I  re- 
ferred to  in  the  introduction  as  the  important  set 
of  facts  I  was  able  to  corroborate  by  outside  evi- 
dence. And  one  of  the  instances  of  undoubted 
affective  dis]f)lacement  whidi  I  had  in  mind  was 
the  incident  which  occasioned  the  severe  attack 
of  fear  just  referred  to.  On  the  day  in  question 
a  nurse  from  the  Board  of  Health  had  called  at 
the  house  during  Stella's  absence,  in  regard  to 
something  in  connection  with  Barney's  case.  But 
Stella's  mother,  who  can  not  speak  English,  did 
not  understand  just  what  was  wanted  and  so  when 
she  told  Stella  about  the  nurse's  visit  Stella  got 
the  impression  that  inquiries  were  being  ntiade  in 


376    MOBBID  FEABS  AND  COMPULSIONS 

regard  to  her  own  tubercular  history.  She  re- 
acted to  this — ^a  thing,  as  we  shall  see  later,  which 
might  well  have  been  the  occasion  for  some  alarm 
— ^by  anxiety  not  about  the  tuberculosis  problem 
but  about  Kishef.  In  short,  she  displaced  her 
emotions  from  the  thoughts  with  which  they  really 
belonged  and  attached  them  to  an  associated  idea, 
the  fear  of  the  fortune  teller.  Just  why  she  se- 
lected this  particular  idea  as  the  one  to  which 
to  make  the  displacement  will  be  explained  later. 

The  knowledge  that  Stella  had  had  tuberculosis 
already  begins  to  throw  a  new  light  on  certain  dark 
problems  of  her  history.  Thus,  it  is  to  be  seen 
that  the  onset  of  her  lung  trouble  coincided  with 
that  mysterious  *' nervous  illness"  in  her  child- 
hood which  followed  the  death  of  her  beloved  Aunt 
Ida,  and  in  which  she  suffered  from  depression, 
anaemia,  and  loss  of  weight.  In  short,  it  is  now 
evident  that  this  early  illness  was  at  bottom  not 
nervous  at  all,  but  physical.  The  anaemia,  loss  of 
weight,  etc.,  were  due  to  the  tuberculosis  directly. 
Nevertheless,  Stella  was  not  altogether  wrong 
when  she  stated  that  this  nervous  illness  was  a 
reaction  to  her  Aunt  Ida 's  death,  as  we  shaU  see 
in  a  moment.  There  was  a  ' 'nervous''  element 
in  it. 

In  the  first  place,  Stella,  after  admitting  that 
she  had  had  tuberculosis,  soon  disclosed  the  fact 
that  Ida  had  died  of  the  same  malady,  instead  of 
''from  worrying  about  something"  as  she  had  at 
first  alleged.  A  fact  of  some  significance  is  that 
Ida's  death  had  followed  very  shortly  after  she 
and  Stella  had  had  a  terrible  quarrel    Stella, 


A  COMPULSION  NEUROSIS         377 

though  extremely  fond  of  her  aunt,  had  neverthe- 
less, in  the  heat  of  this  quarrel,  wished  that  Ida 
would  die.  When,  then,  Ida  did  die,  Stella  more 
than  half  believed  that  this  murderous  wish  had 
killed  her.  And  when  still  later  Stella  found  that 
she  too  had  the  same  malady  of  which  Ida  died, 
she  felt  that  this  disease  had  come  upon  her  as 
a  punishment  for  her  evil  wish.  This  doubtless 
had  something  to  do  with  her  depression.  Inci- 
dentally this  sequence  of  wish,  wish  fulfillment,  and 
punishment  no  doubt  had  a  considerable,  effect  in 
fixing  in  Stella's  mind  a  belief  in  the  power  and 
in  the  punishment  of  evil  wishes,  and  this  belief 
was  apparently  a  factor  in  the  development  of  the 
Kishef  obsession.^ 

The  most  important  consideration  in  connec- 
tion with  Stella's  neurosis  was  not  so  much  that 
she  had  had  tuberculosis,  but  that  people  knew,  or 

iThe  fact  that  Ida  died  of  tuberculosis  did  not  dispel  Stella'a 
belief  that  a  wish  had  killed  her.  It  was  not  known  that  Ida  was 
tubercular  until  a  very  short  time  before  she  died;  not,  in  fact, 
until  after  the  quarrel  that  has  been  spoken  of.  Stella's  idea  was 
that  her  wish  had  caused  Ida  to  become  infected  with  tuberculosis. 

There  is  a  Jewish  superstition  with  which  Stella  was  familiar 
that  in  each  day  there  is  one  minute  during  which  whatever  wish 
a  person  expresses  will  be  omnipotent.  When  Ida  died  Stella 
thought  that  she  had  ''hit  the  minute" — that  her  wish  for  Ida's 
death  at  the  time  of  their  quarrel  had  happened  to  come  at  just 
the  fateful  moment  Just  which  minute  of  any  given  day  was 
the  fateful  one  no  one,  according  to  the  superstition,  ever  knew. 
On  a  number  of  occasions  when  she  wanted  something  very  badly 
Stella  made  the  ingenious  experiment  of  trying  to  wish  for  It 
every  minute  of  the  day  so  as  to  be  sure  to  "hit"  the  particular 
minute  that  conferred  omnipotence.  Unfortunately,  on  every  oc- 
casion she  eventually  went  to  sleep  or  allowed  her  attention  to 
wander  so  that  the  minute  theory  was  never  conclusively  proved 
or  disproved. 


378    MOBBID  PEABS  AND  COMPULSIONS 

might  know,  that  she  had  it    As  she  herself  said, 
'^I  never  worried  so  much  that  I  had  T.  B. — ^I 
wasn't  afraid  of  dying.    What  I  did  fear  was 
that  other  people  wonld  find  out  that  I  was  sick 
and  that  this  would  prevent  me  from  getting  mar- 
ried"   In  fact,  when  Stella  first  developed  tu- 
berculosis she  was  rather  proud  of  it  and  liked  the 
sympathy  and  attention  it  brought  her.    Soon, 
however — ^at  least  by  the  time  she  was  sixteen — she 
took  a  very  different  view  of  the  situation  and 
would  never  admit  to  any  one  that  there  had  been 
anything  the  matter  with  her,  while  she  instructed 
her  parents  and  relatives  to  follow  her  example. 
Her  reason  was,  as  she  said,  that  if  it  were  known 
she  had  once  had  lung  trouble  no  one  would  want 
to  marry  her.    Economic  conditions  are  so  stren- 
uous in  the  sphere  in  which  Stella  lived  that  the 
young  men  cannot  afford  to  let  sentimental  come 
before  practical  considerations  in  choosing  a  wife. 
Thus,  if  a  girl  had  a  tubercular  history,  she  would 
not  be  likely  to  have  any  suitors,  for,  no  matter 
how  attractive  she  might  be,  none  of  the  young 
men  would  care  to  marry  her  and  run  the  chances 
of  being  burdened  with  an  invalid.    That  this  is 
so,  Stella  knew  from  painful  experience.    In  more 
than  one  instance  some  young  man  who  had  been 
pajring  serious  court  to  her  had  suddenly  ceased 
his  attentions  and  avoided  her  thereafter,  while 
investigation  revealed  that  the  knowledge  of  her 
history,  conveyed  to  his  ears  by  some  busybody, 
was  the  cause  of  his  sudden  change  of  front.    In 
Stella's  own  words — ^which,  I  think,  are  not  a  great 


A  COMPULSION  NEUBOSIS         379 

exaggeration — ^'^  Among  the  Jews  on  the  East  Side, 
it  ooold  be  known  of  a  girl  that  she  drank,  that 
she  stole,  or  that  she'd  had  a  dozen  illegitimate 
children,  and  she  'd  still  have  some  chance  of  get- 
ting married  But  if  it  were  known  she  had  T.  B., 
then  as  far  as  marriage  is  concerned  she  might  as 
well  be  dead — ^if  she  lived  for  a  hundred  years  no 
one  would  ever  believe  she  was  really  strong  and 
no  one  would  marry  her.  You  can't  convince  an 
East  Side  Jew  that  any  one  ever  recovers  from 
tuberculosis — ^unless,  perhaps,  he  has  it  him- 
self." 

Now,  in  spite  of  the  fact  that  as  she  grew  older 
Stella  did  everything  in  her  power  to  conceal  her 
tubercular  history,  there  was  always  danger  of 
its  being  found  out,  and  under  the  most  inoppor- 
tune circumstances.  Through  her  visits  to  va- 
rious clinics  and  during  her  sojourn  in  the  two 
sanitaria,  she  had  met  a  great  many  people— pa- 
tients and  others — ^who,  of  course,  learned  that  she 
had  tuberculosis.  On  this  account  her  secret  was 
never  safe  and  the  tuberculosis  problem  conse- 
quently remained  a  constant  source  of  anxiety  and 
dread  because  it  threatened  to  destroy  her  chances 
of  a  satisfactory  marriage.  At  the  same  time  she 
rebelled  against  the  idea  of  concealing  her  history 
from  the  man  whom  she  would  marry,  as  well  as 
that  of  becoming  a  burden  upon  him  should  her 
lung  trouble  recur.  These  conflicts  and  the  part 
they  played  in  producing  the  neurosis  we  shall 
take  up  in  the  interpretation  of  her  earlier  obses- 
sion. 


380    MORBID  FEAES  AND  COMPULSIONS 

(e)  Analysis  of  the  Assault  Obsession 

This  obsession  came  on  at  a  time  of  great  con- 
flict and  difficulty.  In  the  first  place,  Stella  had 
recently  been  deprived  of  a  source  of  sexual  grat- 
ification through  the  incident  which  put  an  end  to 
her  father's  nocturnal  visits.  From  one  stand- 
point she  was  glad  these  visits  had  ceased,  for  she 
no  longer  had  to  reproach  herself  for  permitting 
them.  But,  on  the  other  hand,  she  felt  a  certain 
regret,  for,  in  spite  of  herself,  her  father  was  in  a 
way  more  attractive  to  her  as  a  sexual  object  than 
any  one  else  she  had  ever  known,  and  the  pleasure 
of  his  visits  was  not  easy  to  renounce.  She  knew, 
furthermore,  that  with  merely  a  look  or  a  word  she 
could  give  him  to  understand  that  he  was  welcome 
to  resume  his  attentions,  and  that  he  would  not 
long  delay  in  taking  advantage  of  the  hint.  One 
conflict,  then,  concerned  her  feelings  for  her  father 
and  the  question  of  what  her  attitude  towards  him 
should  be  in  the  future.  That  is,  on  the  one  hand, 
she  wanted  to  get  completely  away  from  his  in- 
fluence, while  on  the  other  she  was  strongly 
tempted  to  give  the  signal  that  would  restore  the 
same  conditions  that  formerly  existed. 

A  still  greater  conflict  arose  in  another  connec- 
tion. The  fact  that  she  was  at  the  time  deprived 
of  her  old  source  of  gratification,  as  well  as  her 
wish  to  break  completely  away  from  her  father, 
predisposed  her  to  welcome  some  new  sexual  ob- 
ject as  a  substitute  for  him.  It  so  happened  that 
such  a  substitute  was  offered.  A  suitor  had  pre- 
sented himself  and  was  highly  favored  by  her  pa- 


A  COMPULSION  NEUROSIS         381 

rents*  She  was  not  in  love  with  him,  it  is  truiB, 
but  he  was  a  manufacturer  and  in  most  comfort* 
able  circumstances,  and  this  was  a  matter  to  which 
she  was  by  no  means  indifferent*  It  is  possible 
that  despite  her  strong  father  complex  a  marriage 
might  have  resulted  had  it  not  been  for  a  compli- 
cation that  had  arisen.  Stella  had  begun  to  feel 
ill,  to  cough,  and  to  lose  weight.  These  symptoms 
gave  her  good  reason  to  fear  that  her  old  tubercu- 
losis was  active  again.  This  made  the  question 
of  marriage  a  most  perplexing  one.  From  one 
standpoint,  a  return  of  her  lung  trouble  was  in 
itself  an  argument  in  favor  of  marriage,  for  mar- 
riage offered  a  most  favorable  opportunity  for 
recovery  from  the  disease.  If  she  were  to  accept 
her  suitor  she  would  be  sure  of  more  leisure,  more 
comforts,  and  better  food  than  had  ever  been  her 
lot  before,  or  than  she  could  obtain  in  any  other 
way,  and  she  knew  that  all  these  things,  in  view  of 
her  health,  were  of  great  importance.  Marriage 
too  would  not  only  give  her  certain  advantages 
in  the  fight  with  disease,  but  would  also  remove 
her  from  a  position  of  great  disadvantage  which 
she  might  otherwise  occupy.  Unless  she  married 
she  would  have  to  work,  and  if  she  kept  on  work- 
ing her  condition  was  almost  certain  to  become 
worse,  so  that  sooner  or  later  she  would  have  to 
give  up  and  go  to  a  sanitarium.  This  latter  pos- 
sibility was  something  she  could  not  face.  Com- 
paratively few  people  knew  of  her  first  attack  of 
tuberculosis,  but,  if  she  had  to  go  to  a  sanitarium 
agaiu,  practically  every  one  of  her  acquaintances 
would  ^ow  it,  she  would  be  branded  as  a  consump- 


382    MOBBID  FEABS  AND  COMPULSIONS 

tive  for  many  years  to  come,  no  matter  how  fully 
she  recovered,  and  her  chances  of  making  a  suit- 
able marriage  in  the  future  would  consequently 
be  reduced  almost  to  zero. 

In  spite  of  the  arguments  in  favor  of  accepting 
her  suitor  there  was  much  to  be  said  against  such 
a  course.  In  the  first  place  she  did  not  love  the 
man.  In  the  second,  she  was  convinced  that  if 
he  knew  her  past  history,  to  say  nothing  of  her 
present  fears,  he  would  drop  her  instantly.  If, 
then,  she  were  to  marry  she  would  have  to  conceal 
everything  pertaining  to  her  tuberculosis  and  to 
do  this  was  most  repugnant  to  her.  Not  only  was 
she  reluctant  to  make  false  pretenses  in  such  a 
matter  as  matrimony,  but,  in  addition  to  this,  she 
would  always  be  in  danger  of  having  her  husband 
find  out  that  he  had  been  deceived,  either  through 
her  developing  active  symptoms  of  the  malady, 
or  from  some  one  who  knew  of  her  earlier  attacks. 

It  is  to  be  seen  that  her  immediate  problems  at 
this  period  centered  upon  the  question  of  whether 
or  not  she  was  really  having  a  relapse.  To  be 
sure,  she  had  symptoms  of  apparently  serious 
import,  but  they  did  not  settle  the  matter  beyond 
all  doubt.  Thus,  she  could  say  to  herself,  ''I  feel 
badly,  it  is  true,  but  how  do  I  know  that  this  is 
tuberculosis t  I  am  no  doctor,  so  I  can't  be  sure. 
Maybe  I  only  imagine  that  I  don't  feel  welL" 
Under  such  circumstances  the  logical  course  would 
have  been  to  go  to  a  doctor  and  have  her  lungs 
examined.  This  would  have  settled  the  question 
immediately.  If  her  lungs  were  found  to  be  nor- 
mal she  could  have  obtained  a  certificate  to  that 


A  COMPULSION  NEUROSIS         383 

effect  and  married  with  a  relatively  clear  con- 
science. Bat  as  a  matter  of  fact  she  was  nnwilling 
to  have  the  question  settled.  In  her  inmost  self 
she  was  practically  certain  that  her  Inngs  would 
not  be  found  normal,  and  she  was  not  disposed  to 
exchange  what  opportimity  she  had  of  doubting 
the  return  of  her  malady  for  the  cold  reality  of 
knowing  it.  On  the  other  hand,  she  had  certain 
resistances  against  marriage  which  were  derived 
from  her  father  complex.  Though  of  course  had 
she  been  examined  and  pronounced  normal  by  a 
physician  she  would  have  been  glad,  nevertheless 
these  resistances  gave  her  a  tendency  to  welcome 
any  excuse  for  not  marrying.  An  excellent  ex- 
cuse would  be  removed  if  she  were  examined  and 
her  lungs  found  normal.  As  was  pointed  out 
much  earlieri  she  had  a  wish  to  return  to  her  for- 
mer relations  wiih  her  father,  but  the  fulfillment 
of  this  wish  was  opposed  by  her  ethical  self.  In 
the  event  of  her  being  deprived  by  tuberculosis  or 
anything  else  of  all  opportunity  to  marry,  the  wish 
for  her  father  would  take  advantage  of  such  a 
situation  and  make  out  of  the  deprivation  an 
excuse  for  a  return  to  him. 

All  these  conflicts  and  difficulties  had  been  in 
existence  before  Stella's  fateful  visit  to  Mrs.  Den- 
zer's,  without,  however,  bringing  forth  a  neuro- 
sis. We  should  suppose,  then,  that  something 
in  this  visit  must  hiave  reenf  orced  these  conflicts 
and  thus  given  rise  to  the  obsession.  And  such 
was  actually  the  case.  As  has  already  been  in- 
dicated, Stella's  immediate  problems  were,  first, 
had  she  tuberculosis  t  and  second,  if  she  had  it 


384    MORBID  FEARS  AND  COMPULSIONS 

should  she  conceal  it  and  marry  in  spite  of  her 
feeling  that  this  was  not  honest  t  If  some  evil 
genius  had  set  out  to  lead  her  into  this  particular 
kind  of  wrongdoing  it  is  doubtful  if  he  could  have 
devised  anything  better  suited  to  his  purpose  than 
simply  taMng  her  to  Mrs,  Denzer's  at  that  par- 
ticular time.  Nowhere  could  he  have  found  an 
argument  in  favor  of  dishonesty  more  subtle  or 
better  calculated  to  appeal  to  Stella  than  that  pre- 
sented by  Mrs.  Denzer's  life.  Like  Stella,  Mrs. 
Denzer  had  had  tuberculosis  as  a  girl — ^in  f  act,  it 
was  in  a  sanitarium  that  they  became  acquainted. 
Like  Stella  again,  Mrs.  Denzer  had  had  a  suitor — 
in  the  person  of  Mr.  Denzer — ^at  a  time  when  she 
was  none  too  sure  of  the  soundness  of  her  health 
and  whom  she  felt  she  would  lose  if  he  knew  her 
history  or  her  condition.  But  at  this  point,  unlike 
Stella,  Mrs.  Denzer  had  not  hesitated.  On  the 
contrary,  she  had  accepted  him  instantly  and  mar- 
ried at  the  earliest  possible  moment  without  ^v- 
ing  the  least  hint  that  she  had  ever  had  trouble 
with  her  lungs.  Her  marriage  turned  out  welL 
Thus,  on  the  fateful  evening  of  the  obsession, 
Stella  beheld  her  in  possession  of  a  nice  home,  a 
devoted  husband,  and  two  fine  diildren,  to  say 
nothing  of  the  best  of  food  to  keep  up  her  strengfli 
and  a  competent  maid  to  relieve  her  of  all  occasion 
for  spending  it  And  when  before  the  eyes  of 
sick,  tired,  and  penniless  Stella  there  was  dis- 
played this  so  seductive  spectacle  which  seemed 
to  say  to  her,  **If  only  you  would  be  dishonest, 
you  too  might  have  all  these  things,"  it  is  not  sur- 
prising that  something  extraordinary  happened. 


A  COMPULSION  NEUROSIS         385 

Let  OB  now  consider  just  what  this  happening 
was.  What,  in  other  words,  was  the  relation  of 
the  ohsession  to  Stella's  various  problems?  It 
will  be  remembered  that  Stella's  first  fear  began 
when  Mr.  Denzer  and  the  two  other  men  returned 
to  the  house,  and  that  it  consisted  in  the  feeling 
that  she  must  remain  no  longer  or  one  of  these 
men  would  assault  her.  As  has  also  been  said, 
she  had  no  actual  reason  to  fear  these  men.  All 
three  of  them  were  attractive  to  her.  Mr.  Denzer 
made  a  great  pet  of  her,  one  of  the  men  had  told 
Mrs.  Denzer  that  he  would  like  to  marry  Stella, 
and  the  other  was  a  medical  student  of  that  re- 
fined type  that  always  excited  her  interest.  Un- 
der ordinary  circumstances  each  might  have  been 
expected  to  excite  desire  in  some  form,  rather 
than  fear.  In  fact,  this  was  the  very  reason  that 
Stella  felt  herself  to  be  in  danger.  The  situation 
was  one  which,  even  before  the  coming  of  the  men, 
presented  colossal  temptations.  The  arrival  of 
the  men,  all  of  whom  were  attractive  to  Stella,  re- 
enforced  the  temptations  to  such  a  degree  that  she 
was  no  longer  sure  of  herself.  She  could  scarcely 
avoid  thinking,  '^Oh,  if  I  were  not  so  honest  I  If 
only  I  had  no  conscience,  what  advantages  and 
what  pleasures  would  be  mine!"  That  is,  if  it 
were  not  for  her  moral  inhibitions  she  could  either 
enjoy  the  sexual,  hygienic,  and  economic  advan- 
tages of  marriage  after  the  manner  of  her  friend, 
or,  throwing  to  the  winds  all  thought  of  marriage, 
go  to  a  sanitarium,  resolved  that  upon  her  recov- 
ery and  return  home  she  would  indulge  herself 
without  limit  in  the  erotic  pleasures  afforded  by 


386    MOBBID  FEABS  AND  COMPULSIONS 

the  paternal  finger.  Her  f ear,  then,  was  a  fear  of 
temptationi  and  expressed  a  wish  to  be  robbed  of 
her  virtae,  and  to  be  ^^ dishonest''  in  one  or  both 
of  the  ways  indicated. 

This  fear  took  the  form  of  a  dread  of  assault 
for  two  reasons.  The  first  was  that  an  assault 
would,  through  no  fault  of  hers,  place  her  in  a  po- 
sition where  she  would  have  comparatively  little 
to  lose  by  further  sexual  activity— would,  in  other 
words,  fulfill  her  wish  to  be  robbed  of  her  con- 
science, or  as  nearly  so  as  such  a  wish  is  possible 
of  fulfillment.  The  second  reason  was  that  the 
words  '^ honest''  and  '^ dishonest"  had  for  Stella 
a  double  meaning.  She  was  accustomed  to  speak 
of  a  virgin  as  an  '^ honest  girl"  (apparently  a  di- 
rect translation  of  ^'ehrliche  Madchen"),  and  thus 
'^honest"  meant  to  her  chaste,  ^'dishonest"  signi- 
fied unchaste,  although  these  words  in  addition 
had  for  her  the  same  meaning  that  is  usually  given 
to  them.  Thus  her  wish  to  be,  or  her  fear  of  be- 
ing, ^^ dishonest"  in  the  usual  sense  of  the  word — 
which  here  referred  to  her  inclination  to  conceal 
her  tuberculosis  and  marry  under  false  pretenses 
as  Mrs.  Denzer  had  done — ^was  represented  in  the 
focus  of  her  consciousness  as  a  fear  of  becoming 
dishonest  in  the  other  meaning  of  the  term.  ^  *  Dis- 
honest" was  thus  a  common  term  which  expressed 
both  types  of  the  temptation  to  which  she  was 
subject. 

During  the  night  the  fear  that  she  would  become 
'^ dishonest"  changed  to  a  feeling  that  she  was 
'^ dishonest" — that  she  had  been  assaulted.  This 
was  brought  about  by  a  feeling  of  certainty  that 


A  COMPULSION  NEUBOSIS         387 

had  oome  to  her  that  she  really  was  again  suffer- 
ing from  tuberculosis.  The  absence  of  menstrua- 
tion she  had  found  to  be  a  symptom,  in  her  case  at 
least,  indicating  that  an  active  pulmonary  process 
was  going  on.  For  several  days  before  going  to 
Mrs.  Denzer 's  she  had  been  expecting  to  be  unwell, 
and  had  the  flow  appeared  she  would  have  been 
relieved.  When,  in  the  morning,  she  awoke  to 
find  that  it  was  still  absent  her  fear  that  she  had 
suffered  a  relapse  changed  to  a  conviction  that 
such  was  the  case  and  thus  dispelled  all  expecta- 
tion that  she  would  be  able  to  lead  the  life  that  her 
conscience  dictated. 

Stella's  obsession  that  she  was  assaulted  in  her 
sleep  represents,  then,  among  other  things,  a  down- 
ward displacement  of  her  tuberculosis  complex. 
Thus  the  fear  she  expressed  to  Bose  that  some- 
thing ^' awful''  had  happened  to  her  and  had  made 
her  body  '^different"  was  fundamentally  correct, 
but  she  located  the  trouble  in  the  wrong  region — 
in  her  genitals  instead  of  her  lungs.  Also  when 
she  went  from  one  doctor  to  another  to  be  exam- 
ined for  a  rupture  of  the  hymen  she  was  carrying 
out  the  perfectly  logical  impulse  to  go  to  a  doctor 
for  an  examination  of  her  lungs.  Her  wish  to  be 
examined  was  entirely  right— 'the  only  thing  wrong 
was  that  she  had  displaced  the  examination  sev- 
eral bodily  segments  downward. 

in  the  same  way  the  obsession,  by  means  of  dis- 
placement, gave  outlet  to  another  impulse.  Stella 
had  threatened  to  tell  her  mother  that  she  had 
been  *' touched"  by  her  father,  but  this  threat  she 
had  not  carried  out.    When  she  developed  the  ob- 


388    MORBID  FEARS  AND  COMPULSIONS 

session  she  did  tell  her  mother  that  she  had  been 
'^touched"  (to  be  touched  is  a  slang  phrase  for 
intercourse — ^a  virgin  is  a  girl  who  **ha8  never 
been  touched '0  ^^^  the  ambiguity  of  the  word 
'Houch"  allowed  her  to  discharge  her  impulse  to 
tell,  but  without  disclosing  just  what  had  occurred. 
This  obsession  lasted  some  months.  Fortu- 
nately Stella  WES  able  to  get  together  enough 
money  so  that  she  could  give  up  her  work  and  go 
to  the  country  for  a  time.  This  change  gave  her 
the  start  she  needed,  so  that  when  she  came  home 
her  physical  symptoms  eventually  disappeared, 
and  after  a  time  she  was  able  to  return  to  her  work 
in  the  store.  Her  obsession  cleared  up  after  the 
symptoms  of  lung  involvement  had  disappeared, 
but  not  until  she  had  at  last  decided  to  refuse  the 
young  man  ** because,"  she  told  herself,  **she  was 
not  a  virgin."  The  obsession  reappeared  from 
time  to  time  up  to  the  beginning  of  the  Kishef  fear, 
though  never  with  any  great  severity.  These  re- 
currences coincided  with  those  times  in  which  she 
had  some  reason  to  doubt  the  soundness  of  her 
physical  health,  or  was  confronted  with  some  sex- 
ual temptation  or  the  problem  of  marriage. 

(/)  The  Role  of  the  Tuberculosis  Complex  in 
Determining  SteUa's  Love  Choice 

When  Stella  had  once  admitted  that  she  had 
had  tuberculosis  her  resistance  diminished  enor- 
mously and  it  was  possible  to  work  out  many 
things  that  had  previously  been  inexplicabia 
Thus,  I  was  able  eventually  to  discover  the  reason 
for  her  sudden  infatuation  for  Max  and  to  answer 


A  COMPULSION  NEUROSIS         389 

the  extremely  baflUng  question  of  why  she  married 
Barney.  Once  she  had  confessed  the  great  secret 
of  her  tuberculosis,  Stella  not  only  ceased  to  deny 
that  I  was  correct  in  my  conclusion  that  she  had 
supposed  Max,  Barney,  and  myself  to  be  tubercu- 
lar, but  she  corroborated  me  in  every  particular. 
Thus,  she  confessed  that  she  felt  Max  was  a  con- 
sumptive from  the  very  first  instant  she  saw  him, 
and  that  she  was  confirmed  in  this  belief,  first,  by 
the  fact  that,  although  apparently  m  love  with  her, 
he  was  so  paradoxically  reticent,  and,  second,  by 
her  learning  that  he,  like  herself,  took  a  six  weeks' 
vacation  every  summer.  For,  said  she,  when  poor 
people  take  long  vacations  it  means  they  have  to 
— ^they  cannot  afford  it  unless  it  is  a  question  of 
health.^ 

Now,  the  singular  fact  that  Stella's  infatuation 
for  Max  and  her  belief  that  he  was  tubercular 
began  at  the  same  instant  was  paralleled  by  a 
similar  occurrence  in  her  affair  with  Barney. 
Now  that  her  resistances  had  diminished,  Stella 
not  only  agreed  that  I  was  right  in  thinking  that 
before  he  was  examined  she  believed  that  Barney 

1  With  the  knowledge  of  tuberculoeU  which  she  had  gained  by 
the  observation  of  her  own  case,  and  through  being  in  clinics  and 
sanitaria,  Stella  was  a  diagnostician  of  no  mean  skill.  Her  abil- 
ity to  detect  tuberculosis  from  the  general  appearance  of  a  person 
was  such  that  a  physician  might  envy  her.  But  a  fact  that  is 
of  more  importance  is  that  she  had  absolute  confidence  in  her 
powers  in  this  line  and  once  she  had  made  up  her  mind  that  a 
person  was  a  consumptive  she  would  have  been  slow  to  change 
her  opinion  even  if  a  physician  skilled  in  physical  diagnosis  had 
disagreed  with  her.  I  mention  this  in  order  to  make  it  plain  that 
though  it  might  seem  that  she  had  insufficient  grounds  for  being 
certain  that  Max  and  Barney  had  tuberculosis  she  umm  certaiuy 
nevertheless. 


390    MORBID  FEABS  AND  COMPULSIONS 

was  a  oonsnmptiyey  bat  ahe  also  told  me  that  even 
before  she  married  him  she  was  oonvinoed  he  had 
the  disease.  In  fact,  her  family  also  suspected  the 
same  thing,  and,  calling  him  ^'der  tote  Mann,^'  did 
everything  in  their  power  to  prevent  the  match.  ^ 
Now,  it  may  be  added,  that  sometime  earlier  in 
the  analysis  Stella  told  me  she  first  felt  that  she 
wanted  to  marry  Barney  jnst  after  he  had  told 
her  he  had  been  giving  some  lectures  at  the  Y.  M. 
H.  A.  The  fact  that  he  lectured,  she  said,  gave 
her  the  impression  that  he  must  be  very  intellec- 
tual, and  for  this  reason  she  felt  she  would  like 
to  marry  him.  When,  after  her  confession,  I  hap- 
pened to  ask  what  first  made  her  suspect  that  Bar- 
ney was  not  well  she  answered  that  whUe  he  was 
telling  her  about  the  Y.  M.  H.  A.  lectures  she  no- 
ticed that  he  was  very  hoarse  and  that  this  imme- 
diately aroused  her  suspicion.  In  other  words, 
in  her  affair  with  Max,  and  again  in  her  affair  with 
Barney,  a  desire  to  marry  had  arisen  exactly  at 
the  same  moment  as  the  st^spicion  that  the  object 
of  this  desire  was  tubercular.  This  looked  to  me 
very  much  as  if  a  causal  relation  had  existed  be- 
tween the  two  phenomena — ^I  mean  to  say,  that  ap- 
parently Stella  had  wanted  to  marry  Max  and 
Barney  because  she  thought  them  tubercular. 
This  sort  of  desire,  at  first  thought,  seems  a  very 

lit  may  be  noted  at  her  firgt  visit  to  me  Stella  said,  in  re- 
sponee  to  my  suggestion  that  she  put  off  her  marriage  for  a  time, 
that  neither  her  own  nor  her  husband's  parents  would  Usten  to 
any  proposal  of  delay.  As  we  have  learned,  quite  the  reverse  was 
fcrue,  at  least  so  far  as  Stella's  parents  were  concerned,  lliey  not 
only  would  have  been  glad  to  have  her  put  off  this  marriage,  bat 
would  have  done  almost  anything  in  their  power  to  prevent  it. 


A  COMPULSION  NEUROSIS         391 

strange  one,  yet  there  were  reasons  enough  for 
its  existing. 

In  the  first  place,  Stella  felt  that  if  she  married 
a  well  man  without  having  sound  health  herself 
she  would  be  doing  wrong  to  her  husband.  But 
if  she  could  pick  out  a  tubercular  husband  she 
would  in  a  way  be  doing  him  no  greater  wrong 
than  he  was  doing  her,  and,  thus,  in  a  sense,  they 
would  be  quits.  Again,  if  she  married  a  well 
man  she  would  have  to  reproach  herself  for  ex- 
posing him  to  infection,  whereas  if  her  husband 
were  already  tubercular  this  occasion  for  self- 
reproach  would  not  exist. 

In  the  second  place,  she  could  look  upon  a  mar- 
riage with  a  tubercular  man  as  a  temporary  one. 
That  is  to  say,  she  could  expect  that  her  husband 
might  die,  and  with  that  superstitious  faith  in  the 
omnipotence  of  her  wishes  which  is  so  common 
among  neurotics,  she  had  a  sort  of  belief  that  he 
would  do  so  when  it  would  most  suit  her  conven- 
ience. Another  reason  for  a  belief  that  such  a 
marriage  would  be  a  temporary  one  was  this.  At 
the  time  she  married,  Stella  knew  practically  noth- 
ing of  the  laws  of  divorce,  and  she  thought  that  if 
she  wished  to  be  free  from  a  tubercular  husband, 
particularly  if  he  were  not  well  enough  to  support 
her,  all  she  would  have  to  do  would  be  to  state 
the  case  before  the  nearest  judge,  and,  provided 
she  successfully  concealed  the  fact  that  she  too 
had  had  the  disease,  he  would  give  her  a  divorce 
instantly. 

The  chief  advantage  of  a  temporary  marriage 
was  that  it  would  give  her  a  chance  for  compara- 


392    MORBID  FEABS  AND  COMPULSIONS 

tive  rest  from  her  work  in  the  store,  to  build  up 
her  healthy  and  thus  get  into  condition  to  make  a 
permanent  marriage  should  the  right  man  come 
along. 

Another  element  in  the  case  was  her  family. 
Because  she  had  had  tuberculosis  they  were  very 
anxious  to  have  her  married  and  off  their  hands. 
In  a  way  she  wanted  to  assist  them  in  this  en- 
deavor,  for  she  realized  that  at  times  she  had 
been  a  great  burden.  But,  on  the  other  hand,  she 
resented  their  anxiety  to  get  rid  of  her,  and  espec- 
ially so  because  they  made  it  pretty  plain  that  on 
account  of  her  history  they  felt  any  husband  who 
could  support  her  was  good  enough  and,  conse- 
quently, never  made  the  slightest  effort  to  get  her 
one  that  would  be  really  worth  while.  Conse- 
quently, Stella  felt  that  it  would  serve  her  parents 
right  if  she  contracted  a  second-rate  marriage, 
and,  as  a  result  of  her  husband's  inability  to  sup- 
port her,  soon  had  to. return  to  the  parental  flat. 
In  other  words,  it  would  give  her  a  certain  spiteful 
satisfaction  to  make  an  unsuccessful  match. 

But  there  was  still  a  more  important  reason 
why  Stella  wished  to  return  home  to  her  parents, 
namely  her  attachment  to  her  father,  which,  it 
need  hardly  be  said,  was  a  very  strong  one.  As  is 
well  known  even  quite  ordinary  family  relations 
between  a  father  and  daughter  are  not  infre- 
quently sufficient  to  produce  such  a  fixation  of 
the  child's  love  upon  the  father  that  she  is  never 
able — or  willing — ^to  transfer  it  to  a  more  suitable 
object.  But  where,  as  in  this  case,  there  had  been 
actual  physical  sex-relation  between  parent  and 


A  COMPULSION  NEUBOSIS         393 

ohild  the  tendency  to  develop  a  fixation  that 
would  form  a  permanent  obstacle  to  normal  trans- 
ference is  of  course  very  great.  In  f act^  it  is  by 
no  means  impossible  that  even  if  there  had  not 
been  the  difficulties  in  the  way  of  marrying  which 
tuberculosis  created,  and  even  if  Stella's  suitors 
had  been  much  more  nmnerous  and  desirable  than 
was  actually  the  case,  she  still  might  have  been 
unable  to  break  away  from  her  father  and  fall  in 
love  in  a  normal  way.  At  any  rate,  since  Stella's 
feelings  toward  her  father  amounted  to  her  being 
consciously  in  love  with  him — ^not  even  stopping 
short  of  the  wish  to  bear  children  by  him — ^it  is 
clear  that,  however  strongly  she  felt  that  she  ought 
to  break  away  from  him  and  form  a  more  normal 
attachment  elsewhere,  she  was  incapable  of  a  thor- 
oughly sincere  effort  in  that  direction,  for  the  wish 
to  succeed  in  it  was  constantly  opposed  by  an 
equally  strong,  even  though  less  clearly  perceived, 
hope  tiiat  she  might  fail  and  so  retain  her  original 
state. 

If  then  we  bear  in  mind  that  because  of  her  love 
for  her  father,  Stella  was  reluctant  to  take  any 
step  that  would  mean  a  permanent  separation 
from  him,  we  are  better  able  and  understand  why 
she  chose  a  consumptive  for  a  husband  and  to  com- 
prehend the  analysis  of  the  Kishef  obsession,  upon 
which  we  are  about  to  enter. 

(g)  The  Affair  with  Max  and  the  Analysis  of  the 

Kishef  Obsession 

In  this  obsession  Stella's  tuberculosis  played 
the  same  role  as  it  had  in  the  assault  obsession. 


394    MOEBID  FEARS  AND  COMPULSIONS 

The  prime  object  of  her  vacation  in  the  coontry 
which  led  to  her  acquaintance  with  Max,  had  been 
the  restoration  of  her  heath.  For  again  the  hard 
work  in  the  store  had  been  too  much  for  her,  and 
she  had  perceived  signs  of  returning  lung  trouble. 
It  is  to  a  recurrence  of  her  tuberculosis  rather 
than  to  the  kind  of  love  described  in  story  books 
that  the  loss  of  weight  and  similar  symptoms 
which  accompanied  her  infatuation  are  to  be  at- 
tributed. 

The  infatuation  itself  was  determined  very 
largely  by  the  elements  we  have  just  described  in 
discussing  the  influence  of  tuberculosis  on  Stella's 
love-choice.  That  is,  although  she  would  not  have 
admitted  it,  she  was  already  alarmed  about  her 
health  and  worried  by  the  knowledge  that  soon  her 
vacation  would  be  over  and  she  would  have  to  go 
back  to  work  in  the  store.  When  with  her  first 
glance  at  Max  she  saw  he  was  tubercular  and  at 
the  same  time  attractive,  she  felt  that  marriage 
with  him  represented  a  way  out  of  her  difficulties, 
and  this  thought,  though  not  clearly  perceived  by 
her  consciousness,  made  her  say  to  herself  ''Here 
is  the  man  I  must  marry,"  and  was  largely  re- 
sponsible for  her  seeming  infatuation.  That  over 
and  above  considerations  of  mere  expediency  Max 
was  extremely  attractive  to  her  can  hardly  be 
doubted. 

When  her  vacation  ended  and  she  returned  to 
work  in  the  store  she  knew  that  the  rest  had  done 
her  comparatively  little  good  and  not  only  that 
she  was  still  far  from  well  but  also  that  she  had  a 
good  prospect  of  becoming  worse  if  she  kept  on 


A  COMPULSION  NEUROSIS         395 

working.  Naturally  she  began  to  feel  that  she 
should  consult  a  doctor,  and  possibly  go  to  a  sani- 
tarium, but  here  again,  as  at  the  time  of  the  as- 
sault obsession,  she  could  not  bring  herself  to  face 
this  painful  necessity,  or,  indeed,  to  admit  that 
it  really  existed. 

When,  earlier  in  the  day  of  her  first  visit  to  the 
Mahoshef,  she  accompanied  Rose  to  St.  Christo- 
pher's Clinic,  thoughts  about  tuberculosis  and  the 
need  of  consulting  a  doctor  must  have  been  in  her 
mind.  To  visit  any  clinic  would  have  inevitably 
brought  up  such  reflections,  but  St.  Christopher's 
was  particularly  well  suited  to  have  this  effect,  for 
Stella  had  been  told  there  by  one  of  the  clinic  phy- 
sicians, when  several  years  earlier  she  applied  to 
be  treated  for  nasal  catarrh,  that  he  found  signs 
of  active  tuberculosis  in  her  lungs. 

Now  that  we  know  that  Stella's  tuberculosis 
complex  must  have  been  stimulated  by  the  visit 
to  the  clinic,  it  is  easy  to  explain  her  sudden  change 
of  front  in  regard  to  consulting  a  Mahoshef.  Be- 
fore going  to  the  clinic  with  Rose  she  had  scoffed 
at  all  that  lady's  suggestions  of  magic,  but  imme- 
diately after  the  visit  she  veered  about  and  ex- 
pressed a  desire  to  see  a  fortune  teller  after  all. 
The  reason  is  plain  enough.  The  need  of  going  to 
a  doctor  for  an  examination  and  treatment  was 
brought  forcibly  to  her  mind  by  going  to  the  clinic. 
She  could  not  bring  herself  to  face  the  ordeal  of 
an  examination,  however.  What  she  did  do,  then, 
was  to  make  a  compromise.  Instead  of  going  to 
a  doctor  she  decided  to  visit  some  one  like  a  doc- 
tor—in short,  a  magician— for  she  had  often  heard 


396    MORBID  FEARS  AND  COMPULSIONS 

from  Rose  and  others  that  these  individuals  could 
cure  all  the  ills  that  flesh  is  heir  to.  Thus  her 
visit  to  the  Mahoshef  was  really  a  substitute  for  a 
consultation  with  a  physician — ^and  the  motive  for 
it  was  a  wish  to  get  rid  of  that  great  obstacle 
to  marriage,  tuberculosis,  rather  than  a  desire  to 
have  Max's  state  of  mind  changed  by  supernatural 
means.  Without  doubt  she  thought  his  mind  was 
in  the  proper  state  anyway — ^that  he  would  marry 
her  if  his  body  were  sound. 

Some  time  before  making  this  visit  Rose  had 
said  to  Stella,  ''You  are  so  much  in  love  with  Max 
that  you'll  make  yourself  sick  worrying  about  hun. 
You  know  you  once  had  hemorrhages,  and  you 
can't  be  very  strong  now.  If  you  let  yourself  get 
so  worked  up  the  old  trouble  may  come  back." 
Stella  replied  to  this  that  she  never  really  had 
tuberculosis  and  tried  to  convince  Rose  that  this 
was  so  without  being  at  all  satisfied  that  she  had 
succeeded,  although  Rose  did  not  dispute  the  point 
and  pretented  to  be  convinced. 

When,  then,  at  their  first  visit  to  the  Mahoshef, 
Rose,  having  preceded  her  into  his  presence,  re- 
turned crying,  **He  knew  what  your  trouble  was 
right  awayl"  Stella,  demonstrating  the  truth  of 
her  own  proverb,  *'Auf  dem  Gonef  brennt  die 
Hiittel,"^  began  to  feel  uncomfortable  and  to 
wonder  if  he  could  possibly  have  guessed  that 
she  had  tuberculosis.  But  at  the  same  instant  it 
dawned  on  her  that  Rose  might  have  given  him 
some  hint  of  her  history,  for,  knowing  that  Rose 
was  suspicious  and  feeling  sure  that  she  had  not 

1  On  the  thief  the  hat  bunii. 


A  COMPULSION  NEUROSIS         397 

fiuoceeded  in  convincing  her  that  she  had  never 
had  the  disease,  Stella  thought  it  not  unlikely  that 
Bose,  shrewdly  suspecting  that  the  problem  of 
tuberculosis  was  worrying  her  a  good  deal,  had 
conununicated  this  suspicion  to  the  Mahoshef  with 
the  kindly  intention  of  giving  him  every  possible 
advantage.  The  vaguo  fear  of  the  Mahoshef, 
which,  as  we  have  said,  Stella  felt  all  through  her 
first  visit,  can  now  be  accounted  for  by  the  fact 
that  she  suspected  that  he  had  some  idea  of  her 
tubercular  history. 

It  will  be  remembered  that  Stella  began  to  be- 
lieve in  the  Mahoshef  when  he  boasted  to  her,  '^I 
can  do  everything;  for  me  all  kinds  of  Kishef  are 
easy."  This  meant  to  her  an  implication  that  he 
could  not  only  make  love  matches  but  also  cure 
diseases,  and  it  was  the  latter  point  that  interested 
her,  for  this  was  just  what  she  had  hoped  he  could 
do.  Her  faith  in  him  which  then  began  was,  in 
part  perhaps,  a  remnant  of  the  old  superstition 
of  her  childhood,  which  had  been  reenf orced  by 
the  wonder  tales  which  Bose  had  told  with  such 
convincing  sincerity,  but  more  largely  it  was  a 
wish  product.  That  is,  she  believed  because  she 
wished  to  believe.  Her  faith  was  the  ordinary 
spes  phthisica  which  leads  consumptive  patients  to 
put  so  much  reliance  on  all  sorts  of  outlandish 
remedies. 

Finally,  the  idea  that  the  Mahoshef  possessed 
the  powers  of  a  doctor,  or  that  he  could  be  re- 
garded as  a  substitute  for  one,  was  strengthened 
when,  as  has  been  said,  he  offered  to  sell  her  a  cure 
for  rheumatism.    Thus,  when  Stella  said  to  Bose 


398    MORBID  FEAES  AND  COMPULSIONS 

after  leaving  the  Mahoshef,  ''I'm  so  happy,  now 
I  can  marry  Max,"  her  thought  was  ''Perhaps  the 
Mahoshef  can  core  Max  and  me  of  tabercnlosis 
and  thus  make  it  possible  for  us  to  marry,"  rather 
than  any  idea  that  some  change  in  Max's  emo- 
tional state  was  to  be  brought  about. 

In  her  conversation  with  Rose  two  days  later 
Stella  said,  "I  had  rather  get  him  in  ti^e  right 
way.  After  we  are  married  I  will  tell  him  all 
about  it."  And  what  she  had  in  mind  was  her 
tuberculosis  history.  Her  words  were  clearly  the 
result  of  a  feeling  that  for  her  to  marry  without 
telling  her  suitor  of  her  history  was  a  "wrong 
way ' '  of  getting  a  husband 

At  the  same  time,  these  remarks  show  that  her 
faith  in  the  ability  of  the  Mahoshef  to  cure  her 
was  by  no  means  absolute,  for  had  she  been  posi- 
tive that  he  could  make  her  entirely  sound  and 
well  she  would  have  felt  little  guUt  about  marry- 
ing, no  matter  what  her  past  history  had  been. 
When,  then.  Rose  told  the  story  of  the  man  who  by 
drinking  menstrual  blood  was  made  to  love,  Stel- 
la's already  overtaxed  credulity  gave  way,  for  to 
be  confronted  with  the  task  of  believing  a  tale  so 
utterly  absurd  and  beyond  the  bounds  of  probabil- 
ity was  the  proverbial  last  straw.  Thus,  without 
clear  consciousness  of  doing  so,  she  had  to  think, 
"If  Rose  can  believe  a  thing  so  foolish  as  that, 
how  can  I  put  any  confidence  in  her  when  she  teUs 
me  that  the  Mahoshef  has  such  wonderful  powers  T 
What  a  fool  I  have  been  to  think  he  could  cure 
tuberculosis  1 "  ^ 

1  Probably  the  esflential  nature  of  these  thoughts  is  that  ori^ 


A  COMPULSION  NEUROSIS         399 

It  was  natural,  then,  that  when  a  moment  later 
Bose  said,  '^Do  yon  know,  Stella,  that  if  Max  has 
magic  done  to  him  he  will  be  weak  and  sickly  all 
his  life  and  can't  live  to  be  over  fifty,  if  even  that 
longT"  there  should  form  somewhere  in  Stella's 
mind  the  ironical  and  contemptuous  reflection 
which  may  be  expressed  as  follows:  /'Indeed, 
you  are  more  right  than  you  realize,  friend  Bose ; 
he  tuiU  always  be  weak  and  sickly  if  he  has  magic 
done  to  him — and  if  he  doesn^t  have  it  done  to 
himl  He  has  tuberculosis,  and,  in  spite  of  what 
any  Mahoshef  or  doctor  can  do  for  him,  he  will  al- 
ways be  weak  and  sickly,  and  of  tuberculosis  he 
will  die."^  But,  naturally,  there  also  came  the 
thought  ''The  same  thing,  I  fear,  is  true  of  me," 
which  was  formulated  in  the  same  ironical  way, 
"Just  as  truly  as  Max  is  going  to  die  of  Kishef, 
80  truly  I  am  going  to  die  of  it.  The  same  sort  of 
magic  that  will  cause  his  death  will  also  cause 
mine  (that  is,  what  we  will  die  of  will  be  tubercu- 
losis). This  thought,  then,  "I  am  going  to  die 
of  the  fortune  teller's  Kishef  {in  the  same  way 
as  is  Max)/^  which  is  simply  another  way  of  say- 
ing/^I  have  tuberculosis,  and  I  will  never  be  cured 
of  it,"  formed  the  starting  point  of  her  obsession. 

To  gain  some  understanding  of  why  this  thought 
became  obsessive,  that  is  to  say,  why  all  the  affects 
belonging  to  the  tuberculosis  complex  were  trans- 

inaUy  th^  were  wordless,  altbough  I  am  here  obliged  to  express 
them  in  words. 

^This  pessimistic  reflection  corresponds  to  the  opinion  regard* 
ing  the  curability  of  tuberculosis  which  is  held  by  the  old-fash- 
ioned Jews  of  Stella's  acquaintance.  Most  of  them  believe  that 
real  consumption  can  never  be  cured. 


400    MORBID  FEAES  AND  COMPULSIONS 

f erred  to  it,  we  need  only  to  represent  to  ourselves 
what  must  have  been  the  state  of  Stella's  mind 
at  that  time.  The  theme  of  tuberculosis  was  one 
that  for  a  long  time  she  had  not  faced  squarely. 
As  soon  as  she  began  to  realize,  in  her  girlhood, 
that  tuberculosis  would  diminish  her  value  in  the 
eyes  of  men,  she  not  only  denied  to  others  that 
she  had  had  the  disease  but  refused  to  admit  even 
to  herself  that  she  had  ever  had  it.  Thus,  she  dis- 
puted the  significance  of  repeated  hemorrhages, 
loss  of  weight,  cough,  and  similar  symptoms,  and, 
although  all  the  doctors  who  ever  examined  her  at 
the  times  she  showed  symptoms  had  made  the 
same  diagnosis  of  tuberculosis,  she  always  told 
herself  that  as  the  result  of  prejudice  or  some 
other  influence  they  were  mistaken,  basing  this 
contention  on  the  fact  that  she  had  never  had  a 
positive  sputmn,  and  that  for  the  greater  part  of 
her  life  she  had  maintained  fairly  good  health 
though  working  in  an  unfavorable  climate  and 
under  unfavorable  conditions. 

But  for  Stella  to  maintain  a  conscious  belief 
that  she  was  not  and  had  never  been  tubercular 
would  mean  simply  that  she  repressed  and  refused 
to  admit  to  her  consciousness  various  perceptions 
that  would  inevitably  lead  to  the  formation  of  a 
directly  opposite  opinion.  In  other  words,  even 
supposing  that  she  could  believe  consciously  that 
she  never  had  had  the  disease,  yet  unconsciously 
she  entertained  an  entirely  different  conviction. 
Thus,  though  at  the  time  of  her  affair  with  Max 
she  kuew  in  a  way  that  she  was  having  a  relapse. 


A  COMPULSION  NEUROSIS         401 

she  would  not  admit  to  herself  that  such  was  the 
case. 

The  concern  consequent  upon  her  unwilling  and 
unadmitted  knowledge  of  her  condition  was  tem- 
porarily diminished  by  her  visit  to  the  Mahoshef , 
f or,  with  a  faith  like  that  which  a  drowning  man 
has  in  a  straw,  she  had  hoped  that  he  would  be 
able  to  do  away  with  her  malady.  But  in  a  mind 
so  shrewdly  materialistic  as  Stella's  any  belief  in 
his  powers  was  of  necessity  short  lived.  The  ab- 
surdity of  Rose's  story  of  menstrual  blood  as  a 
love  potion  was  enough  to  swing  her  back  to  her 
normal  position  of  incredulity.  Thus  as  her  tran- 
sitory faith  in  the  Mahoshef  gave  way  she  was 
plunged  into  a  state  of  despondency  in  which  she 
was  on  the  point  of  admitting  not  only  that  she 
really  was  sick  but  that  perhaps  she  might  always 
be  so,  but  Rose's  remark,  which  caused  her  to 
think,  '^I  am  going  to  die  of  Kishef  (in  the  same 
way  as  is  Max),"  supplied  at  the  critical  moment 
tf  euphemistic  phrase  with  which  to  make  the  ad- 
mission. To  say,  ^^1  am  going  to  die  of  Kishef/' 
since  Kishef  was  a  thing  she  really  neither  be- 
lieved in  nor  feared,  was  less  painful  than  the  bald, 
cold  statement  ^^I  have  tuberculosis,  and  it  is  of 
that  I  must  eventually  die."  But  no  matter  how 
delicately  expressed,  a  thought  having  such  a 
meaning,  and  coming  as  it  did  at  the  moment  when 
a  forlorn  hope  had  just  been  destroyed,  was  in- 
evitably accompanied  by  intense  and  disagreeable 
emotions.  The  thought  **I  am  going  to  die  of  the 
fortime  teller's  Kishef"  appeared  in  Stella's  con- 


404    MORBID  FEARS  AND  COMPULSIONS 

The  thoughts  from  which  affective  displacement 
came  about  by  this  route  arose  as  follows.  Not 
only  did  Rose  divine  the  facts  with  Kishef-like  ac- 
curacy in  her  prediction  concerning  the  health  of 
Max,  but  also,  it  seemed  to  Stella,  in  another  con- 
nection. It  will  be  remembered  that  early  in  the 
analysis  we  learned  that  Stella  wished  tha^  if  Max 
turned  out  to  be  a  helpless  invalid  after  she  mar- 
ried him,  his  life  would  be  short.  Because  of  these 
wishes  she  could  regard  herself,  as  far  as  her 
thoughts  were  concerned,  as  a  murderess.  It  was 
also  pointed  out  that  in  connection  with  Ida's  death 

before  they  went  to  him  changed  what  had  been  in  the  first  place 
only  a  vague  suspicion  into  a  practical  conviction  that  Roae  had 
betrayed  her.  For  the  fact  that  Rose  had  seen  fit  to  conceal  this 
acquaintance  indicated  a  certain  duplicity  on  h^  part,  while  the 
existence  of  the  acquaintance,  implying  as  it  did  that  Rose  had 
confided  in  the  man  and  had  some  secret  understanding  with  him, 
made  it  seem  highly  probable  that  she  had  told  him  all  she  knew 
about  Stella.  Thus,  it  is  to  be  seen  that  the  reason  Stella  became 
angry  at  Rose  when  she  discovered  the  old  acquaintance  between 
her  and  the  Mahoshef  was  that  this  discovery,  to  Stella's  mind, 
represented  quite  positive  evidence  that  Rose  had  betrayed  her. 
She  was  angry  at  Rose's  seeming  untrustworthiness,  for  she  felt 
that  if  that  young  lady  could  so  readily  betray  the  great  secret 
to  the  Mahoshef  she  might  just  as  readily  betray  it  to  almost 
any  one  else,  and  where  such  a  betrayal  would  be  much  more 
serious.  Another  element  was  the  fact  that  Stella  felt  no  small 
resentment  toward  Robc  because  the  latter  had  apparently  refused 
to  be  convinced  that  Stella  was  not  a  consumptive.  Stella's  wish 
to  convince  Rose  of  the  soundness  of  her  health  was  at  bottom 
a  wish  to  convince  herself.  Her  resentment  at  Rose's  apparent 
skepticism  thus  oorresponds  to  that  familiar  phenomenon  known 
as  the  projection  of  a  reproach. 

It  must  be  added,  however,  that  Stella's  anger  at  Rose  was  not 
quite  as  real  as  it  seemed.  That  is  to  say,  it  served  as  an  over- 
compunction  for  a  feeling  of  a  different  sort — a  matter  which  will 
be  clearer  when  we  take  up  the  wish  element  in  the  obsession. 


A  COMPULSION  NEUEOSIS         405 

Stella  did  regard  herself  as  a  murderess  not  only 
in  thought^  but  also  in  f act^  for  she  believed  that 
fihe  had  killed  Ida  with  an  evil  wish.  Stella  could 
think  of  herself  as^  potentially,  a  murderess  for 
still  another  reason,  for  she  was  not  sure  that  she 
would  not  adopt  some  means  of  hastening  Max's 
departure  more  material  than  mere  wishes  if  after 
she  married  bitri  he  became  incapacitated  and  lin- 
gered on  a  hopeless  invalid  unable  to  support  her. 
Indeed,  the  fact  that  she  had  something  of  this 
sort  in  mind  explains  her  exclamation,  ''I  can't 
bear  to  have  a  man's  days  shortened  for  my  pleas- 
ure! I  can't  have  him  lose  his  life  on  my  ac- 
count I "  ^  But  it  is  clear  that  though  SteUa  had  a 
certain  basis  for  saying  to  herself,  '^I  am  a  mur- 
deress," it  was  an  admission  that  she  would  have 
been  very  reluctant  to  make;  and,  consequently, 
her  mind  would  automatically  take  advantage  of 
any  mechanism  representing  an  escape  from  a 
thought  so  painfuL  Such  a  means  of  escape  was 
provided  in  this  way.  When  Rose  had  said  of 
Max,  ^^If  he  has  Kishef  done  to  him  he  can't  live 
to  be  over  fifty,"  Stella  of  course  thought,  ^^  When- 
ever Max  dies,  no  matter  of  what  cause,  Rose  will 
think  that  it  was  Kishef  that  killed  him ;  and,  since 
I  am  the  one  who  caused  the  Kishef  to  be  done, 
Bose  will  look  upon  me  as  a  murderess."  And, 
as  we  have  just  shown,  Bose,  in  Stella's  opinion, 
would  be  right  in  thinking  her  a  murderess.    Here 

1  After  she  married  Barney  and  St  became  evident  that  his 
health  was  failing  she  often  had  impulses  to  choke  him  or  poison 
him  and  was  by  no  means  always  sure  that  she  would  not  act 
upon  them. 


406    MOBBID  FEAES  AND  COMPULSIONS 

again  Rose,  though  through  wrong  premises, 
would  reach  a  oorrect  conclusion  in  a  way  so  re- 
markable  that  it  could  be  thought  of  as  mind  read- 
ing or  **Kishef/'  Of  this  figurative  way  of  ex- 
pressing the  disagreeable  fact  that  Rose's  esti- 
mate of  her  would  be  in  a  way  true,  Stella's  mind 
took  instant  advantage.  Hence,  instead  of  saying 
to  herself,  '^Bose  will  be  right  if  she  thvnks  lamQ 
murderess,*^  or,  in  other  words,  instead  of  putting 
the  psychic  accent  on  the  last  part  of  the  ideas 
represented  by  the  above  sentence,  where  it  be- 
longed, her  mind  accented  the  first  part,  the  idea 
^^Bose  guesses  my  thoughts  rightly,"  which  as  she 
thought  in  Yiddish  would  have  the  form,  ''That 
Machseveh  is  doing  Kishef  to  me"  (Die  Mach- 
seveh  tut  mir  Kishef) ;  and  this  thought,  construed 
literally  by  her  consciousness,  and  further  dis- 
torted by  the  condensation  whereby  the  masculine 
''Mahoshef "  was  substituted  or  merged  with  the 
feminine  ''Machseveh,"  bore  with  it  all  the  affects 
of  displeasure  and  self-reproach  originating  from 
the  unwilling  knowledge  of  her  murderous  tend- 
encies.^ 

But  still  another  group  of  ideas  came  to  be  rej)- 
resented  in  Stella's  consciousness  by  her  fear  of 
the  Mahoshef.  Not  only  in  the  two  connections 
just  spoken  of  but  in  still  another  Bose  had  seemed 
to  divine  what  Stella  was  thinking;  for  as  has  al- 
ready been  said,  Stella  thought  that  Bose  guessed 
that  she  was  worrying  about  tuberculosis.  She 
felt  sure  that  when  they  discussed  the  matter  of 

1  Compare  the  diBCuasion  of  thing^ideaa  and  word-ideaa  in  CShap- 

tap  IV. 


A  COMPULSION  NEUROSIS         407 

hemorrhages  Bose,  though  pretending  to  be  im- 
pressed by  her  protestations,  was  really  not  at  all 
convinced  that  Stella  had  never  had  the  disease. 
And  Bose's  warning,  *^If  you  worry  so  about  Max, 
T.  B.  will  come  back  on  you"  had  made  Stella  won- 
der if  Bose  did  not  suspect  that  this  had  already 
occurred  and  that  it  was  a  return  of  the  T.  B.  more 
than  any  thoughts  about  Max  that  was  the  real 
source  of  her  worry.  So,  too,  when  they  went  to 
the  Mahoshef  SteUa  thought  it  not  improbable 
that  if  Bose  told  him  anything  about  her  history 
she  had  added,  ''and  very  likely  she  is  not  feeling 
any  too  strong  now,  which  may  be  the  reason  she 
seems  so  worried."  ^ 

1  It  Ib  perhaps  tme  that  Stella's  grounds  for  thinking  that  Bose 
had  divined  and  perhaps  disclosed  to  others  that  her  tuberculosis 
had  recurred  were  not  particularly  good  ones.    As  a  matter  of 
fact»  for  Stella  to  fear  that  another  had  guessed  her  secret — a 
aecrety  be  it  remembered^  which  she  hardly  admitted  to  herself—- 
did  not  require  sound  logical  grounds.    It  is  well  known  a 
guilty  person  fears  in  a  characteristically  illogical  way  that  his 
guilt  is  suspected  by  others,  even  by  those  who  cannot  possibly 
know  anything  about  it.    In  the  same  way  it  often  happens  that 
a  person  thinks  that  another  suspects  him  of  something  that  he 
consciously  believes  he  is  not  guilty  of  but  of  which  he  is  actually 
guilty,  though  unconsciously.    One  of  my  patients,  for  example, 
who  developed  a  neurosis  diortly  after  he  became  engaged,  told 
me  he  believed  a  friend  of  his  suspected  that  he  became  ill  only 
as  a  means  of  backing  out  of  his  engagement;  and,  as  it  turned 
out  eventually,  a  wish  to  withdraw  from  the  engagement  actually 
was  one  of  the  chief  determinants  of  his  illness.    But  at  the  time 
he  became  iU  this  wish  was  a  totally  unconscious  one.    Phenom- 
ena of  this  sort  are  well  known  under  the  term,  '^e  projection 
of  a  reproach,"  and  that  the  existence  of  this  mechanism  is  well 
recognized  is  evidenced  by  such  familiar  phrases  as:  *'A  guiliy 
oonseience  needs  no  accuser.*'    "The  wicked  flee  when  no  man  pur- 
sueth.''    To  some  extent,  then,  Stella's  thought  that  Rose  and  the 
Mahoshef  knew  she  had  tuberculosis  depended  upon  a  projection 


408    MOBBID  FEABS  AND  COMPULSIONS 

At  any  rate,  for  Bose  to  gaess  that  Stella  was 
having  a  relapse — for  in  fact  Stella  was  fat  and 
looked  perfectly  well — ^was  remarkable  enongh  to 
be  expressed  in  terms  of  mind  reading  or  divina- 
tion«  Hence,  whatever  affects  belonged  to  the 
idea  ^  ^  That  I  have  tabercnlosis  is  known  to  others ' ' 
conld  be  displaced  in  Stella's  consdoosness  to  the 
idea  '^The  Mahoshef  is  doing  magic  to  me.'' 

This  point,  that  magic  meant  among  other  thingfs 
to  have  knowledge  of  the  secret  of  her  tuberculosis, 
has  been  emphasized  because  upon  it  depended 
some  of  the  minor  fears  from  which  Stella  had 
suffered.  Since  for  her  to  think  a  person  was 
doing  magic  to  her  could  be  a  substitute  for  the 
thought  that  that  person  knew  of  her  tuberculosis, 
one  can  understand  why  she  had  fears  of  friends 
of  the  Mahoshef,  of  people  who  stared  at  her  on 
the  street,  and  of  the  doctor  who  hypnotized  her 
at  the  Broadway  Clinic.  All  of  these  persons 
she  had  reason  to  think  knew  or  might  know  that 
she  was  a  consumptive.  She  feared  friends  of  the 
Mahoshef,  and  under  this  guise  friends  of  Bose 
also,  because  she  thought  Bose  and  the  Mahoshef 
were  untrustworthy  persons  and  might  betray  her 
secret  to  their  acquaintances.  She  feared  the  doc- 
tor at  the  Broadway  Clinic  because  her  old  tuber- 
culosis histoty  was  there  on  file,  and  he  might  have 
seen  it  or  have  learned  of  her  story  from  some  of 

of  the  represBed  thought  **I  know  I  have  it/'  This  thought^  ^ 
know  I  have  tuberculosis/'  then,  contributed  to  the  obsessioii 
through  two  mechanisms:  first,  identification  with  Max;  second, 
that  of  projection.  In  addition,  as  we  shall  learn  shortly,  there 
was  a  wish  element  in  the  case  that  made  Stella  exaggerate  any 
real  likelihood  of  her  tuberculosis  becoming  known  to  others. 


A  COMPULSION  NEUROSIS         409 

the  men  in  the  department  for  tuberculosis. 
(This  particular  physician  served  also  as  a  substi- 
tute for  several  physicians,  at  this  clinic  and  else- 
'  where,  who  might  tmow  of  her  lung  trouble.)  The 
reason  that  she  feared  that  people  who  stared  at 
her  on  the  street  were  doing  magic  to  her  was  this. 
Any  one  is  apt  to  think  when  he  sees  another  per- 
son staring  at  him,  ^'Is  that  some  one  who  knows 
me  but  whom  I  do  not  recall!"  but  Stella  would 
add  to  such  a  thought,  ''Is  that  some  one  who 
kiJbws  me  from  having  seen  me  in  a  sanitarium  or 
T.  B.  clinic,,  and  so  is  aware  that  I  am  a  consump- 
tive!'' a  thought  which,  because  of  her  resistances, 
reached  her  consciousness  as  a  fear  of  divination 
or  of  magic. 

But  there  remains  still  another  determinant  of 
Stella 's  obsession  to  be  considered.  We  have  seen 
that,  according  to  the  wording  of  the  young  lady's 
obsession,  the  source  of  all  her  troubles  was  the 
Mahoshef  •  It  was  he  and  his  influence  which,  it 
seemed  to  her,  menaced  her  mental  integrity  and 
after  her  marriage  threatened  to  bring  about  a 
divorce  from  her  husband.  The  role  which  the 
Mahoshef  played  in  her  obsession  was,  then,  quite 
analogous  to  that  occupied  by  the  arch  persecutor 
in  the  delusions  of  a  paranoiac.  But  we  have 
come  to  believe  that  in  paranoia  and  allied  condi- 
tions the  person  hated  and  feared  as  the  arch 
persecutor  either  is,  or  represents,  some  one  whom 
the  patient,  usually  without  realizing  it,  actually 
loves.*    It  is  not  unreasonable  to  conclude,  then, 

1  Freud — Psvchoanalytische   Bemerkungen    fiber    einen   autobi- 
ographiBch  beschriebenea  FaU  von  Paranoia.    Jahrbuch  f  Or  Pay- 


410    MORBID  FEARS  AND  COMPULSIONS 

that  a  similar  state  of  affairs  must  have  existed 
in  this  case.  But,  since  there  is  no  reason  to  think 
that  Stella  loved  the  Mahoshef,  it  wonld  seem  that 
he  must  have  stood  as  a  representative  of  some 
one  whom  she  really  did  love.^  The  power  which 
to  Stella  seemed  to  emanate  from  the  Mahoshef 
we  may  suppose,  then,  was  really  her  love  for  this 
person  whom  the  Mahoshef  represented.  Thus, 
as  we  might  naturally  expect,  magic  or  Eashef 
was  a  symbol  for  love,  for  in  the  figures  of  ordi- 
nary speech  love  is  spoken  of  as  a  magical  power, 
a  form  of  enchantment,  the  lover  is  said  to  be  be- 
witched by  his  mistress,  and  she  to  have  cast  a 
spell  over  him,  etc  '^The  Mahoshef  is  doing 
magic  to  me''  means  then,  among  other  things,  '^I 
am  in  love  with  him/'  i.  e.,  with  some  person  whom 
the  Mahoshef  represents. 

But  who  was  the  person  loved  by  Stella  and 
represented  in  the  obsession  by  the  Mahoshef! 
There  seems  to  be  little  room  for  doubt  on  this 
point.  All  the  evidence  indicates  that  Stella's 
father  was  the  person  in  question.  As  has  al- 
ready been  said,  she  was  in  love  with  him  in  the 
fullest  sense  of  the  word.  She  wished  to  remain 
with  him,  to  assume  the  place  occupied  by  her 
mother,  and  to  be  sexually  gratified  by  him. 

choanalytische  und  Psychopathologische  ToTBchnngm,  BcL  m. 
Bit.  1,  1912. 

1  This  line  of  reasoning  has  brought  us  to  a  oondnsion  almost 
identical  with  that  reached  when  before  beginning  the  analysis 
we  were  considering  the  question  of  love  at  first  sight»  namely, 
that  Stella  must  have  been  in  love  with  some  person,  then  un- 
known to  us,  and  that  presumably  this  love  was  an  important 
factor  in  the  development  of  the  neurosis. 


A  COMPULSION  NEUEOSIS         411 

These  wishes  were  opposed  and  to  some  extent 
obscured  by  others  of  an  ethical  order  which  im- 
pelled her  to  marry  and  leave  home.  But  the 
conflict  of  these  f  orces,  reenf  orced  by  the  conflicts 
arising  out  of  the  tnbercalosis  problem,  eventually 
resulted  in  a  sort  of  pseudo-marriage — ^a  marriage 
with  a  consumptive.  That  is  to  say,  her  love  for 
her  father  led  her  to  contemplate  and  eventually 
to  take  a  step  which  must  lead  to  infinite  trouble, 
anxiety,  and  unhappiness.  It  is  evident,  then, 
that  if  all  of  Stella's  troubles  could  be  attributed 
to  the  influence  of  any  one  person,  that  person  was 
not  the  Mahoshef,  but  her  father.  From  the 
standpoint  of  harm  done  he  was  the  real  Maho- 
shef. He,  and  not  the  fortune  teller,  was  the  one 
who  ** bossed''  her  thoughts,  had  ** power"  over 
her,  and  was  ^'driving  her  crazy,''  or  as  we  can 
better  express  it,  to  do  ** crazy"  things.  **The 
Mahoshef  is  doing  magic  to  me  and  I  am  going  to 
die — or  go  crazy"  is  then  a  substitution  for  the 
thought  ^^I  am  in  love  with  my  father,  and  this 
love  is  leading  me  to  do  insane  things  that  will 
lead  to  my  destruction." 

In  addition  to  the  factors  just  mentioned  there 
were  stUl  others  which  had  some  influence  in  caus- 
ing Stella  to  identify  the  Mahoshef  with  her  father. 
The  fact  that  the  two  men  were  of  about  the  same 
age  and  appearance,  and  that  they  were  both  ob- 
viously old-fashioned  and  superstitious,  without 
doubt  had  some  significance.  Furthermore,  both 
were  in  some  degree  deserving  of  the  term  Maho- 
shef in  its  colloquial  significance  of  rascal.  But 
a  more  important  factor  was  this.    It  will  be  re- 


413    MORBID  FEABS  AND  COMPULSIONS 

membered  that  Stella's  visit  to  the  Mahoshef  was 
really  a  substitute  for  going  to  a  doctor.  Now, 
the  idea  of  visiting  a  physician  had  for  Stella  a 
peculiar  significance.  As  a  little  girl  of  nine  or 
thereabouts  she  and  other  little  girls  had  been 
wont  to  amuse  themselves  by  *  Splaying  doctor.*' 
They  examined  one  anotheri  pretended  to  deliver 
each  other  of  babies,  administered  enemas,  etc. 
But  the  most  interesting  form  of  ^^ treatment'' 
which  took  place  in  these  games  consisted  in  the 
masturbation  of  the  ^'patient''  by  the  pretended 
medical  man.  Thus,  the  idea  of  going  to  a  doctor 
for  examination  and  treatment  was  always  asso- 
ciated in  Stella's  mind  with  some  thought  of  sex- 
ual gratification  by  means  of  masturbation.  For 
the  same  reason  a  doctor,  or  more  especially  a  per- 
son who,  though  not  actually  a  medical  man  as^ 
sumed  the  role  of  one,  as  did  the  Mahoshef,  could 
stand  as  a  dispenser  of  masturbatic  gratification^ 
and,  consequently,  as  a  substitute  for  her  father, 
who  had  afforded  her  pleasures  of  that  sort.^ 
The  starting  point  of  the  identification  seems  to 
have  been  the  moment  when  during  her  first  visit 
to  him  the  Mahoshef  took  Stella's  hand  and  so  held 
it  that  his  thumb  was  interlocked  with  hers  in  a 
peculiar  way,  of  which  she  says,  ^'It  made  me 
think  of  sexual  intercourse." 

iThiB  same  idea  of  playing  doctor  obviously  had  to  do  with 
the  assault  obsession.  Her  repeated  visits  to  physidans  at  that 
time  signified  among  other  things  a  vish  to  have  restored  the 
masturbatic  visits  of  her  father,  which  had  terminated  just  before 
this  obsession  began.  She  wanted  to  be  "examined"  or  "treated" 
in  the  earlier  sense  of  the  words,  but  her  father,  the  "doctOT* 
■he  really  wanted,  she  would  not  go  to  for  the  purpose  directly. 


A  COMPULSION  NEUEOSIS         413 

Up  to  this  point  the  ideas  which  determined 
Stella's  obsession  have  been  considered  purely 
as  painful  ones  and  little  has  been  said  about 
trishes  having  anything  to  do  with  it.  We  are 
taught,  however,  that  the  wish  element  is  inva- 
riably present  in  any  neurosis  and,  as  will  shortly 
appear,  this  case  was  no  exception  to  the  general 
rule. 

Stella  was  of  a  very  passionate  nature  and  had 
possessed  almost  from  her  girlhood  an  intense 
longing  for  sexual  intercourse.  But  though  at 
times  she  had  been  sorely  tempted  to  do  otherwise 
she  had  resolutely  deferred  any  fulfillment  of  this 
wish,  partly  on  account  of  moral  considerations, 
but  more  largely,  as  she  was  well  aware,  because 
she  expected  to  marry  eventually  and  felt  that  it 
would  be  highly  inadvisable  for  her  to  be  lacking 
in  the  physical  evidences  of  virginity  when  that 
event  should  take  place.  But  she  could  expect 
to  marry  only  if  she  preserved  good  health — or  at 
least  the  appearance  of  it — ^and  succeeded  in  keep* 
ing  her  tubercular  history  more  or  less  secret.  If 
it  were  evident  that  she  was  a  consumptive  or  if 
her  history  became  widely  known,  then  the  chances 
of  her  making  a  satisfactory  marriage  would  be 
reduced  to  a  practical  zero,  and  consequently  the 
consideration  which  had  been  most  potent  in  with- 
holding her  from  gratifying  her  desire  for  inter- 
course would  no  longer  exist.  And  she  felt — or 
feared — that  if  there  were  no  practical  advantage 
in  keeping  her  hymen  intact,  then  mere  ethical 
considerations  alone  would  be  insufficient  to  pre- 
vent her  from  yieldiag  to  the  temptation  to  have 


414    MORBID  FEARS  AND  COMPULSIONS 

sexnal  intercourse.^  Furthermore,  she  had  often 
said  to  herself  that  a  girl  who  liirough  such  a 
stroke  of  ill  fortune  as  having  tuberculosis  was 
deprived  of  an  opportunity  to  secure  the  advan- 
tages of  marriage  was  on  Hie  whole  morally  justi- 
fied in  compensating  herself  for  such  a  hard  fate 
by  taking  advantage  of  any  opportunity  for  en- 
joyment that  was  presented  to  her,  whether  sanc- 
tioned by  convention  or  not  It  is  to  be  seen,  then, 
that  for  Stella  to  say  to  herself,  ''You  are  never 
going  to  be  well,  and  there  are  so  many  people  who 
do  know,  or  through  Rose,  the  Mahoshef  and 
others,  will  know  of  your  trouble  that  you  will 
have  no  chance  of  marrying  a  desirable  man''  was 
practically  the  equivalent  of  saying,  ''There  is  no 
longer  any  particular  reason,  moral  or  otherwise, 
why  you  should  not  have  sexual  intercourse  if  you 
want  if  The  fear  of  the  Mahoshef  then  both 
from  the  point  of  view  of  its  face  value — ^since  it 
represented  her  as  being  "bossed''  by  some  one 
else  or  about  to  be  deprived  of  her  reason  and  con- 
sequently as  not  responsible  for  her  acts — and 
in  view  of  its  inner  meaning,  "I  am  going  to  die 
of  Kishef  in  the  same  sense  as  is  Max ;  my  tuber- 
culosis is  divined  by  so  many  that  my  chances  of 
marriage  are  spoiled,"  was  a  wtsh-ftdfiUment  in 
the  sense  that  it  represented  various  excuses  for 
doing  as  she  pleased,  particularly  in  matters  of 
sex. 

1  That  the  temptation  was  a  real  one  la  indicated  by  the  fact 
that  she  had  a  great  many  dreams  which  upon  analysis  proved 
to  be  prostitution  fantasies.  The  financial  as  well  as  the  sexual 
element  played  an  important  role  here. 


A  COMPULSION  NEUROSIS         415 

It  must  not  be  thought  from  this  that  Stella 
ever  ceased  to  want  to  be  well  or  to  have  other 
people  think  her  so.  She  wanted  these  things 
very  much  and  the  thought  that  she  might  not  get 
them  was  indeed  painful.  And  she  was  on  the 
whole  willing  to  lead  a  moral  and  virtuous  life  as 
long  as  she  could  think  it  probable  that  in  the  end 
she  would  be  rewarded  by  securing  the  sort  of 
husband  that  would  suit  her.  At  the  same  time, 
the  more  the  probability  of  her  getting  this  reward 
was  decreased  the  greater  was  the  tendency  for 
her  libido  to  revert  to  former  interests  within  the 
family,  and  to  fantasies  of  prostitution.  That 
portion  of  her  libido  that  was  directed  progres- 
sively toward  the  goal  of  a  suitable  marriage,  im- 
pelled her  to  repress  or  belittle  any  indications 
that  she  was  not  or  could  not  be  physically  well, 
while  the  portion  directed  regressively  towards 
her  father  or  towards  immediate  and  financially 
profitable  gratification  had  just  the  opposite  effect, 
and  impelled  her  to  exaggerate  the  obstacles  in 
the  way  of  matrimony.  Thus  when  circumstances 
were  such  that  she  had  definite  reasons  for  saying, 
''There  isn't  much  use  in  my  being  good,  for  the 
chances  of  my  getting  a  suitable  husband  are 
smalV  there  was  always  an  impulse  to  think  ''I 
have  no  chance  of  getting  a  good  husband,  there 
is  no  use  in  my  being  good — Whence  I  no  longer  have 
to  control  myself,"  thoughts  which  of  course  were 
apt  to  come  to  her  consciousness  in  a  more  or  less 
distorted  form.  The  various  obstacles  to  mar- 
riage represented  in  her  obsession  were  painful 
in  so  far  as  she  desired  a  suitable  marriage  and 


416    MORBID  FEABS  AND  COMPULSIONS 

the  eventaal  sexual  outlet  it  would  represent,  bat 
pleasing  in  so  far  as  she  desired  an  excuse  for 
retoming  to  her  father  and  for  gaining  a  sexual 
oatlet  immediately. 

One  reason  that  she  sought  to  make  a  tem- 
porary marriage  instead  of  gratifying  herself 
without  any  formality  was  in  part  because  she  was 
not  sure  tiiat  she  would  not  eventually  recover 
and  have  a  chance  to  make  a  satisfactory  mar- 
riage. A  temporary  marriage  allowed  her  to 
mark  time  until  she  could  know  more  definitely 
whether  she  was  going  to  recover  fully  or  not 
If  she  should  regain  her  health  she  could  then 
decide  either  to  remain  with  her  husband  or  else 
seek  to  make  a  permanent  marriage  elsewhere, 
while  on  the  other  hand,  if  she  found  herself  get- 
ting worse  it  would  be  time  enough  to  return  to 
her  father  or  indulge  with  other  men  who  took 
her  fancy.  In  the  meantime  she  could  get  what 
sexual  gratification  her  husband  might  be  able 
to  give  her,  though  she  did  not  expect  that  it  would 
be  very  much. 

This  meager  expectation  was  realized,  for  coitus 
with  Barney  rarely  gave  her  pleasure,  though  it 
was  her  resistances  just  as  much  as  any  weak- 
ness on  his  part  that  was  responsible  for  this. 
That  is  to  say  she  would  not  allow  herself  to  love 
him  or  to  enjoy  herself  with  him.  To  love  him 
meant  to  be  in  a  state  where  she  would  want  to 
be  faithful,  unselfish,  and  devoted,  but  the  pros- 
pect of  being  faithful,  unselfish,  and  devoted  to  a 
penniless  consumptive,  especially  when  she  her- 
self was  one,  was  so  uninviting  that  her  mind  auto- 


A  COMPULSION  NEUEOSIS         417 

matically  resisted  whatever  tendency  she  had  to 
make  the  transfer  of  libido  that  would  resnlt  in 
her  wishing  to  do  these  things.  Thus^  though 
she  was  bound  legally  she  was  not  bound  emo- 
tionally. Her  attitude  on  the  whole  was  one  of 
waiting  for  the  time  to  arrive  when  either  she 
would  be  well — ^when  she  would  want  to  get  rid 
of  Barney  and  make  a  better  marriage— or  when 
she  would  know  positively  that  she  was  not  going 
to  recover^  at  which  time  she  would  think  about 
promiscuous  gratification. 

We  can  now  understand  why  she  was  afraid 
that  if  the  Mahoshef  was  making  her  insane  Bar- 
ney would  divorce  her.  This  fear  can  be  trans- 
lated as  follows:  ''If  it  is  true  that  like  Max  I 
will  always  be  a  consumptive,  and  consequently 
cannot  look  forward  to  a  satisfactory  marriage 
even  if  I  am  moral,  I  will  cease  to  be  a  responsible 
person — ^in  short  I  will  lose  control  of  myself  and 
do  things  which  will  g^ve  Barney  full  grounds  for 
a  divorce. '  *  That  the  sort  of ' '  Kishef ' '  her  father 
exerted  upon  her  was  also  an  element  in  this  fear 
need  hardly  be  said.  The  ideas  represented  by 
her  obsession  (namely:  that  she  was  incurably 
tubercular  and  that  too  many  people  knew  of  her 
condition  for  her  to  have  a  chance  to  make  a  suit- 
able marriage),  all  of  which  amounted  to  the 
thought  that  there  was  no  particular  use  in  her 
being  moral,  and  also  the  thought  that  she  was  in 
love  with  her  father,  corresponded  to  the  main 
sources  of  her  resistances  against  Barney.  Her 
love  for  her  father  gave  a  motive  for  not  loving 
her  husband  and  the  fact  that  her  own  health  was 


418    MORBID  FEAES  AND  COMPULSIONS 

poor  she  used  as  an  excuse  for  not  iwRlriTig  the 
best  of  things  after  he  became  an  invalid.^ 

The  Significance  of  the  Return  of  the  Kishef  Ob- 
session, and  Further  Details  of  Interpretation 

When,  shortly  after  the  Kishef  obsession  first 
appeared,  Stella  of  her  own  accord  went  to  the 
Broadway  Clinic  for  treatment,  her  action  was 
altogether  similar  to  that  of  her  making  repeated 
visits  to  doctors  at  the  time  of  the  assault  obses- 
sion. In  both  instances  she  felt  that  there  was 
something  wrong  with  her  lungs  and  that  she 
should  be  examined.  But  in  the  one  case  she  di- 
rected the  examination  to  her  genitals  and  in  the 
other  to  her  mind,  carefully  avoiding  the  critical 
region  of  the  thorax.    But  though  when  she  went 

iThe  fear  of  insanity  and  divorce  had  a  further  detenninant 
than  the  one  just  mentioned.  When  the  oheeseion  first  dereloped 
she  feared  that  as  a  result  of  the  fortune  teller's  magic  she  would 
die.  When  she  first  met  Barney  he  happened  to  speak  one  day  of 
flarry  Thaw  and  stated  (incorrectly,  but  Stella  did  not  Imow 
this)  that  Mrs.  Thaw  divorced  her  husband,  when  after  the  mur- 
der he  was  declared  insane.  It  was  then  that  Stella  feared  that 
through  Kishef  she  too  would  become  insane,  and  that  when  she 
married  her  husband  could  divorce  her  on  that  ground.  This 
fear  obviously  corresponds  to  an  identification  with  Thaw— -or  in 
other  words,  with  a  murderer,  who,  however,  was  excused  by  the 
law.  The  reason  for  this  identification  was  that  she  thoni^t 
that  if  she  got  well  and  Barney  did  not,  she  would  wish  him 
dead  or  perhaps  kill  him,  while  if  she  didn't  get  well  and  had  no 
chance  to  make  a  better  marriage  her  love  would  then  revert  to 
her  father  and  she  would  wish  her  mother  dead.  (If  die  had  a 
satisfactory  husband  she  would  not  have  been  jealous  of  her 
mother  nor  had  the  fears  to  which,  at  the  beginning  of  the  analy- 
sis, we  referred  as  manifestations  of  a  desire  to  replace  her 
mother.) 


A  COMPULSION  NEUROSIS         419 

to  the  Broadway  Clinic  she  entered  the  wrong  de- 
partment yet  she  was  in  the  right  clinic  for  a  lung 
examination  to  be  made.  For  this  was  the  clinic 
at  which  she  had  been  examined,  and  from  which 
she  was  sent  to  a  sanitarium  when  she  suffered 
from  tuberculosis  as  a  child.  Her  old  history  was 
still  on  file  there,  and  some  of  the  doctors  who  at- 
tended her  in  that  early  period  were  still  con- 
nected with  the  clinic.  She  did  get  into  the  tuber- 
culosis clinic  eventually  and  received  treatment 
there  up  to  the  time,  when,  after  Max  went  out  of 
her  life,  she  became  well  enough  to  work  again  in 
the  store. 

The  return  of  her  obsession  in  the  spring  coin- 
cided with  a  renewal  of  conditions  practically 
identical  with  those  under  which  it  first  made  its 
appearance.  Barney  came  into  Stella's  life  about 
the  time  Max  went  out  of  it,  but  naturally  it  was 
some  little  while  before  she  began  to  think  of  him 
seriously  as  a  possible  husband.  But  at  the  time 
she  met  Barney  she  was  being  courted  by  another 
man,  Lehmann.  We  have  already  said  that  as 
time  went  on  Stella  became  secretly  engaged  to 
Barney.  But  as  I  eventually  learned,  Stella,  as 
if  to  make  assurance  doubly  sure  in  respect  to  get- 
ting a  husband  when  she  wanted  one,  became  at 
the  same  time  secretly  engaged  to  Lehmann.  She 
remained  engaged  to  these  two  men  until,  shortly 
after  her  obsession  returned,  she  suddenly  mar- 
ried Barney  at  the  City  Hall.  Not  until  after  this 
event  did  she  inform  Lehmann  that  she  was  not 
to  be  his.  As  has  been  said  much  earlier,  I  was 
convinced  that  Stella  would  have  greatly  preferred 


420    MORBID  FEABS  AND  COMPULSIONS 

Lehmann  to  Barney.  I  did  not  understand  ^y 
she  married  Barney  nntil  the  following  informa- 
tion came  to  light  Lehmann  went  South  in  the 
fall  of  1910  and  expected  to  return  in  January. 
Later  be  wrote  Stella  that  he  had  been  delayed 
by  business  matters  and  his  return  was  postponed 
indefinitely.  For  a  time^  however,  he  kept  up  an 
active  correspondence  with  her,  but  then  suddenly 
his  letters  ceased.  Almost  simultaneously,  his 
sister  who  had  made  it  a  point  to  call  upon  Stella 
every  week  suddenly  ceased  her  visits.  As  Stella 
learned  eventually  the  reason  for  this  was  that 
Lehmann  and  his  sister  had  both  been  taken  seri- 
ously ill,  but  this  she  did  not  know  until  after  she 
married  Barney.  In  other  words,  she  of  course 
thought  that  the  sudden  cessation  of  Lehmann 's 
letters  and  his  sister's  visits  had  only  one  cause 
— ^namely  that  some  one  had  told  the  Lehmann 
family  that  she  was  a  consumptive.  Her  sudden 
decision  to  marry  Barney  was  in  part  a  reaction 
to  the  reflection  that  Lehmann  was  out  of  her 
reach. 

But  a  more  potent  reason  for  this  sudden  mar- 
riage was  the  fact  that  the  symptoms  of  aotive 
tuberculosis  which  had  subsided  in  December  were 
again  returning.  In  fact  she  gave  up  her  work 
again  and  went  back  to  the  Broadway  Clinic  where 
she  was  under  treatment  up  to  within  six  weeks 
of  her  marriage.  Her  decision  to  marry  Barney 
was  then  in  some  degree  a  result  of  the  reflection 
that  he  was  a  last  resort.  She  felt  if  she  did  not 
take  him  she  might  never  get  another  chance  to 
marry,  for  if  she  got  much  worse  she  would  have 


A  COMPULSION  NEUROSIS         421 

to  go  to  a  sanitarinin,  and  with  that  she  thought 
her  morality  would  come  to  an  end. 

The  return  of  her  obsession  just  before  St,  Pat- 
rick's Day  was  a  reaction  to  the  conditions  just 
described.  When  the  girl  in  the  store  said  of  the 
Saint,  '^He  was  the  one  who  drove  the  snakes  out 
of  Ireland"  Stella  thought  something  of  this  sort, 
"That  is  a  likely  story  I  If  I  could  believe  that 
(viz. :  that  one  man  could  rid  a  country  of  snakes) 
I  could  believe  the  impossible."  But  the  impossi- 
ble seemed  to  her,  about  that  time,  to  be  a  com- 
plete recovery  from  tuberculosis.  She  was  suf- 
ficiently discouraged  by  the  return  of  her  pulmon- 
ary symptoms  to  be  on  the  point  of  saying,  *  *  There 
is  no  use  deceiving  myself  any  longer — ^ITl  never 
be  really  well."  Hence  the  impossible  story  of 
St.  Patrick  and  the  snakes  could  connect  with  her 
tuberculosis  complex.  Her  thought  was  some- 
thing like  this,  **  Yes,  if  St.  Patrick  could  drive  the 
snakes  out  of  Ireland  (a  thing  which  I  believe  im- 
possible) then  the  Mahoshef  could  do  magic  to  me 
— that  is,  could  cure  my  tuberculosis,  which  also 
I  believe  to  be  impossible."  Thus  the  return  of 
the  obsession  corresponded  to  an  ironical  com- 
ment on  the  hopelessness  of  her  disease,  or  in 
other  words,  to  the  same  sort  of  thought,  occur- 
ring under  similar  discouraging  circumstances  as 
that  with  which  the  obsession  started  in  the  first 
instance.  And  just  as  the  idea  "My  tuberculosis 
is  known"  was  one  of  the  important  determinants 
at  the  time  the  obsession  first  appeared,  so  it  was 
now;  in  this  case  it  referred  pnntiarily  to  fhe 


422    MOEBID  FEARS  AND  COMPULSIONS 

events  which  had  led  her  to  believe  that  the  Leh- 
maniiB  had  learned  of  her  malady. 

In  the  light  of  our  knowledge  of  the  motives 
which  led  Stella  to  marry  Barney  and  of  the  dr- 
eomstances  under  which  the  marriage  took  place, 
we  are  able  to  understand  a  number  of  the  minor 
features  of  the  case  the  meaning  of  which  has  here- 
tofore not  been  apparent.  At  her  first  visit  to  me, 
Stella  expressed  the  fear  that  the  Mahoshef  was 
making  her  insane  and  that  consequently  she  ought 
not  to  marry  for  by  doing  so  she  would  inevitably 
bring  trouble  and  unhappiness  upon  her  husband. 
As  was  pointed  out,  her  belief  that  she  ought  not  to 
marry  could  not  be  regarded  as  merely  a  logical 
deduction  from  her  obsessive  fear  of  the  Maho- 
shef, but  must  have  depended  on  other  considera- 
tions which  adequately  justified  it.  We  now 
know  what  these  considerations  were.  She  mar- 
ried knowing  that  six  weeks  earlier  when  she  last 
visited  the  Broadway  Clinic  signs  of  tuberculosis 
were  present  in  her  lungs,  she  believed  Barney 
was  also  a  consumptive,  she  was  not  in  love  with 
him,  and  she  did  not  intend  that  their  marriage 
should  be  a  permanent  one.  In  short,  she  had  the 
best  of  reasons  for  feeling  she  ought  not  to  marry, 
and  that  trouble  and  unhappiness  must  inevitably 
result  if  she  did.  Her  fear  of  the  Mahoshef  might 
therefore  from  one  point  of  view  be  regarded  as  an 
explanation  of  these  feelings  which  she  had  ac- 
cepted because  it  was  less  painful  to  her  than  the 
true  one. 

Her  desire  to  have  Dr.  Dana  and  me  assure 
her  that  her  fears  of  insanity  were  groundless  and 


A  COMPULSION  NEUEOSIS         423 

that  -there  was  no  reason  why  she  should  not  marry 
amounted  to  a  wish  to  shift  to  some  one  else  the 
responsibility  of  her  doing  something  she  felt  to 
be  wrong.  But  under  the  circumstances  it  is  easy 
to  understand  why  any  assurances  she  received 
gave  her  no  permanent  satisfaction  and  failed  to 
do  away  with  her  feeling  of  guilt. 

It  was  her  perfectly  well  founded  sense  of  guilt 
which  caused  her  to  make  against  Barney  and  his 
sister  the  reproaches  to  which  reference  was  made 
early  in  the  analysis,  and  which  we  have  con- 
cluded could  be  turned  against  herself.  She  ac- 
cused Barney  of  having  married  her  only  to  have 
her  work  for  him,  because  one  of  the  chief  reasons 
ehe  had  married  him  was  to  have  him  work  for 
her — ^she  wanted  some  one  to  support  her  in  or- 
der that  she  might  have  an  opportunity  to  recover 
her  physical  health  without  going  to  a  sanitarium. 
But  as  she  had  not  intended  to  remain  bound  to 
Barney  after  that  end  was  attained,  or  in  the  event 
of  his  lung  trouble  depriving  him  of  the  ability  to 
support  her,  she  brought  against  him  the  reproach 
that  if  she  became  IQ  (insane)  he  would  instantly 
get  rid  of  her  and  marry  Ada.  Her  bitter  resent- 
ment at  being  required  to  work  after  she  married 
him — ^which  was  particularly  venomous  upon  that 
occasion  when  she  had  to  go  out  in  a  snow  storm 
— ^was  peculiarly  significant  in  view  of  the  fact 
that  one  of  her  chief  reasons  for  marrying  was  her 
wish  to  be  relieved  of  the  menace  to  her  health  in- 
volved in  having  to  work  and  the  exposure  to  in- 
clement weather  which  this  had  necessitated. 

She  reproached  Barney's  sister  with  having 


424    MORBID  FEARS  AND  COMPULSIONS 

been  a  false  friend  becanse  she  herself  had  been 
false.  If  she  had  been  a  true  friend  to  the  girl, 
she  would  not  have  married  her  brother  under  dr- 
eumstances  that  could  mean  nothing  else  than  ul- 
timate disaster.  In  truth,  she  had  '^  roped  in" 
Barney,  and  it  was  because  the  accusation  to  that 
effect  which  Barney's  sister  Esther  made  was,  in 
substance,  true,  that  Stella  so  deeply  resented  it 
In  the  same  way,  another  of  Esther's  statements, 
**She  was  a  sick  g^rl  when  you  married  her"  en- 
raged Stella  because  of  its  essential  correctness. 

The  fact  that  Stella  must  have  been  sure  that 
at  the  time  of  her  wedding  her  tuberculosis  was 
still  active — she  could  hardly  believe  that  in  the 
six  weeks  that  elapsed  between  her  last  visit  to 
the  Broadway  Clinic  and  the  day  of  her  wedding 
she  could  have  made  an  absolute  perfect  recovery 
— accounts  for  her  having  concealed  from  me  the 
fact  of  her  civil  marriage  to  Barney  which  took 
place  at  the  City  Hall.  That  is,  the  reflection  that 
she  could  not  have  been  well  when  she  married 
made  her  overcautious,  and,  as  the  probability 
that  she  still  had  pulmonary  signs  at  the  time  of 
her  marriage  varied  inversely  as  the  length  of 
time  that  elapsed  between  her  last  examination  at 
the  Broadway  Clinic  and  the  day  of  her  marriage, 
she  was  anxious  to  represent  this  time  to  be  as  long 
as  possible  and  so  she  concealed  from  me  the  fact 
of  her  first  wedding  ceremony. 

The  reason  Stella  seized  every  opportunity  to 
quarrel  and  find  fault  with  Barney  in  the  few  days 
that  preceded  his  departure  for  Oakwood  was  that 
this  was  a  time  when  she  was  especially  conscious 


i 


A  COMPULSION  NEUROSIS         425 

of  a  sense  of  guilt.  For  Oakwood  was  one  of  the 
two  sanitaria  in  which  she  had  been  a  patient  in 
her  girlhood.  The  thought  that  he  was  going  to 
an  institution  where  she  herself  had  stayed 
brought  vividly  to  her  mind  the  deceit  she  was 
practicing  upon  him,  and  especially  so  since  she 
felt  that  he  might  meet  some  patient  or  attendant 
who  would  remember  her  and  accidentally  disclose 
her  history.  (As  a  precaution  against  any  such 
misadventure  she  secretly  removed  from  Barney's 
suit  case  a  photograph  of  herself  he  had  intended 
to  take  with  him,  for  she  was  afraid  that  some  one 
might  see  it  and  exclaiming,  ^^Oh,  I  know  that 
girl,  she  used  to  be  a  patient  here,''  thus  disclose 
the  secret  of  her  history.)  But  as  a  defense 
against  the  guilty  feeling  which  then  possessed 
her  she  reacted  by  trying  to  find  Barney  guilty 
of  something  and  by  blaming  him  instead  of  her- 
self. 

ConcUision 

After  Stella  had  confessed  to  me  that  she  had 
had  tuberculosis,  some  six  or  eight  weeks  were 
spent  in  working  out  and  discussing  with  her  the 
various  explanations  that  have  been  here  set  forth. 
Her  fear  of  the  Mahoshef  and  of  Eishef  then  dis- 
appeared entirely  and  has  never  returned  since. 
A  minor  obsessive  idea  relating  to  morality,  which 
she  had  had  throughout  the  greater  part  of  the 
time  she  was  coming  to  me,  still  persisted,  so  that 
even  though  she  had  improved  remarkably  she 
was  not  entirely  welh  (This  minor  obsession  has 
not  been  mentioned  here.) 


426    MOBBID  PEABS  AND  COMPULSIONS 

At  this  point  the  analysis  was  intennpted  and 
I  have  done  no  work  of  any  consequence  on  the 
case  since.  As  soon  as  Stella  told  me  that  she  had 
had  tnbercolosis  I  of  course  sent  her  to  be  exam- 
ined by  an  expert  internist.  He  reported  that 
though  it  was  evident  she  had  once  had  active  ta- 
berculosis  the  process  appeared  to  be  entirely 
healed  and  there  was  nothing  to  be  feared  at  the 
time.  Eight  weeks  later  she  had  some  bloody  ex- 
pectoration, and  upon  examining  her  again  he  re- 
ported that  she  did  have  a  few  signs.  But  she 
began  to  lose  weight,  so  as  soon  as  possible  I  sent 
her  to  the  country,  where  in  a  comparatively  short 
time  she  gained  thirty  pounds.  Her  mental  con- 
dition remained  exactly  the  same  as  it  had  been 
when  she  left.  When  she  returned  from  the  coun- 
try, her  husband  soon  joined  her  and  they  de- 
parted for  a  place  where  they  thought  they  could 
make  a  living  and  at  the  same  time  be  benefited  by 
a  more  favorable  climate.  Soon  after  reaching 
this  new  home,  however,  Barney  began  to  drink 
heavily — ^this  he  had  never  done  before.  His 
health  immediately  showed  the  effects  of  the  dissi- 
pation and  he  died  in  about  a  year.  Stella  kept 
her  physical  health  and  on  the  whole  has  been 
very  well  mentally.  She  writes  me  that  occasion- 
ally she  has  fears  ^' about  morality"  but  that  they 
are  neither  constant  nor  very  distressing. 

Lest  the  reproach  be  made  against  me  that  in 
the  beginning  I  neglected  the  physical  aspects  of 
this  case,  I  wish  to  state  that  I  made  a  careful  ex- 
amination of  Stella's  heart  and  lungs  when  she 
first  came  to  me,  but  found  nothing  pathologicaL 


A  COMPULSION  NEUROSIS         427 

She  was  distinctly  fat  all  through  the  period  I 
knew  her,  and  there  was  nothing  in  her  appearance 
or — save  a  slight  ansemia  in  her  blood  examination 
— to  suggest  that  she  was  tubercular.  The  anae- 
mia was  no  more  marked  and  in  no  way  differed 
from  that  often  found  in  women  with  severe  neu- 
roses. I  may  add  that  she  was  examined  by  a 
number  of  neurologists  about  the  time  she  came 
to  me  and  that  they  too  failed  to  find  anything  in 
her  lungs.  But  in  view  of  what  she  eventually 
told  me  of  her  physical  symptoms  during  this 
period,  and  of  the  findings  of  the  physician  in  the 
tuberculosis  department  of  the  Broadway  Clinic, 
I  think  it  highly  probable  that  she  did  have  signs 
at  the  time  I  first  examined  her,  but  that  they  were 
so  obscure  that  to  detect  them  it  would  have  re- 
quired some  one  more  skilled  in  making  pulmon- 
ary examinations  than  is  the  average  neurolo^st. 
I  am  surprised  not  that  the  patient  failed  to  be- 
come entirely  well  after  the  analytic  work,  but,  on 
the  contrary,  that  she  improved  so  much.  Though 
she  gained  a  considerable  understanding  of  why 
she  was  sick  the  analysis  stopped  before  the  resist- 
ances were  sufficiently  overcome  for  her  to  set 
about  making  the  adjustments  in  her  life  that 
should  follow  upon  a  complete  understanding  of 
the  mechanism  of  the  illness.  It  is,  I  think,  now 
quite  generally  understood  that  psychoanalysis 
cures  not  so  much  through  its  leading  patients  to 
know  in  detail  why  they  are  sick,  but  through  the 
changes  and  readjustments  in  their  lives  which 
they  are  enabled  to  make  in  the  light  of  this 
knowledge.    Beyond  the  fact  that  Stella  eventually 


428    MOBBID  FEABS  AND  GOMFUISIONS 


told  Bamey  of  her  tabercnlar  history  she  made 
no  definite  attempts  at  readjustment  or  toward 
improving  her  life  with  him. 

The  history  of  Stella 's  tuberculosis  is  of  course 
the  set  of  facts  which  in  the  introduction  I  re- 
ferred to  as  having  been  established  by  external 
evidence.  On  reading  over  what  I  have  written, 
it  appears  to  me  that  in  my  desire  to  make  the 
confirmable  facts  conspicuous  I  have  made  them 
seem  unduly  important — or  rather,  that  their  con- 
spicuousness  has  overshadowed  and  obscured  the 
importance  of  the  wish  element,  and  particularly 
the  sexual  wish  element  in  the  case.  Despite  the 
fact  that  the  problem  of  tuberculosis,  as  such,  was 
very  important  to  Stella,  nevertheless  it  alone 
would  have  never  given  rise  to  an  obsession.  It 
was  from  her  unsatisfied  desire  for  sexual  grati- 
fication that  much  of  the  real  driving  force  of  her 
obsessions  was  derived.  Both  obsessions  tended 
to  fulfill  this  wish  by  representing  that  that  con- 
sideration which  made  for  chastity  had  ceased  to 
obtain.  In  the  one  case  she  feared — ^wished — 
that  through  no  fault  of  hers  she  had  lost  her 
chastity,  a  state  of  affairs  which  appealed  to  her 
because  she  could  feel  that  by  sexual  indulgence 
she  had  nothing  further  to  lose.  In  the  other  case, 
she  felt  that  she  was  "bossed"  by  an  evil  person, 
that  her  mind  was  leaving  her,  and  that,  conse- 
quently, she  would  not  be  to  blame  for  whatever 
acts,  sexual  or  otherwise,  she  chose  to  perform. 

By  way  of  emphasizing  these  facts  it  may  be 
well  for  me  to  include  here  a  piece  of  information 
which,  among  many  others,  I  had  intended,  for  the 


A  COMPULSION  NEUROSIS         429 

sake  of  brevity,  to  leave  out  At  the  time  of  the 
assault  obsession  Stella,  though  apparently  in  an 
extremity  of  fear  that  her  hymen  had  been  rup- 
tured, made  repeated  attempts  to  rupture  it  with 
her  finger,  and  was  deterred  from  accomplishing 
her  purpose  only  by  the  pain  that  these  efforts  in- 
volved. She  continued  these  attempts  until,  after 
having  visited  the  woman  physician  who  has  been 
spoken  of,  she  finally  obtained  a  certificate  to  the 
effect  that  her  hymen  had  been  ruptured  by  va- 
ginal examination — L  e.,  in  a  perfectly  legitimate 
way.  Such  seemingly  paradoxical  behavior  on 
Stella's  part  can  be  understood  only  if  we  re- 
member that  her  fear  that  she  had  been  robbed  of 
her  chastity  was  really  a  wish  for  such  to  be  the 
case.  Clearly  enough,  what  she  really  wanted  to 
get  rid  of  was  not  her  hymen  but  that  ethical  part 
of  her  personality  which  withheld  her  from  sexual 
gratification.  But  since  her  ethical  self  was  not 
done  away  with,  neither  fears,  certificates  nor  any 
other  of  her  justification  mechanisms  ever  re- 
sulted in  her  doing  what  she  wished  to  do.^ 

iFor  the  sake  of  accuracy  I  should  perhaps  say  that  what  I 
have  spoken  of  in  this  chapter  as  Stella's  desire  ''for  intercourse" 
could  really  be  separated  into  several  constituents.  Curiosity,  a 
wish  to  experience  everything  her  mother  had  experienced,  and 
certain  perverse  tendencies  corresponding  to  childhood  concep- 
tions of  the  sexual  act  composed  a  large  part  of  this  desire.  (See 
the  further  reference  to  Stella  in  Chapter  VIII.) 


CHAPTER  Vm 

THB  P8TCHOL06T  OF  AHZIXT7  HT8IXBIA. 

MOBBID  fears  of  jpeychonearotic  origin 
(i.  e^  those  not  belonging  to  psychoses, 
to  toxic  deliria,  etc)  come  under  the 
head  either  of  the  compnlsion  nenrosis  or  of  anxi- 
ety  fiysieria.**"  TEeTaRef  "Term,  as  we  have  sai< 
before^  now  includes  the  condition  called  the  anxi- 
ety nenrosifl,  L  6.,  th6fle  Cftfies  in  wl 


nrn  ill  a  iTTiii « VEE 


f a($tOTff  are  tn  tne  foreground  in  causing  the  dam- 
ming  up  of  the  IIBidb.    "' 

Anxiety  hysteria  is  lEe  commonest  of  all  the 
psychoneuroses.  It  may  occur  at  any  time  of 
lif  e,  and  is  common  in  childhood,  while  the  com- 
pulsion neuroses  rarely  develop  in  any  obvious 
form  until  after  the  attainment  of  puberty.  It  is 
the  neurosis  most  frequent  in  women,  while  the 
compulsion  neurosis  occurs  most  often  in  men. 
The  vast  majority  of  cases  carelessly  called 
*' neurasthenia,^'  '^nervous  breakdown"  or  just 
*^  nervousness '^  are  really  examples  of  anxiety 
hysteria. 

While  in  conversion  hysteria  the  symptoms  are 
chiefly  somatic,  and  in  the  compulsion  neurosis  a 
mixture  of  various  emotional  and  volitional  dis- 
turbances appears,  the  chief  manifestation  of 
anxiety  hysteria  is  morbid  fear  ImiT  the  physical 

accompaniments  there(^  These  fear  symptoms 

"«o  " 


PHOBIA  AND  PANIC  431 

may  be  divided  mto  two  sorts,  the  ^^  phobia  ^^  and 
the  **pa£c/| 

For  instaBce,  a  woman  suffers  from  the  fear 
of  being  on  the  street  alone.  While  she  is  at 
home  she  is  comparatively  though  not  absolutely 
free  from  anxiety.  Also,  she  can  go  walking 
upon  the  street  that  leads  from  her  home  to  her 
husband's  office,  and  for  a  certain  distance  on 
6ome  of  the  side  streets,  but  outside  of  this  very 
limited  orbit  she  is  afraid  to  venture  unaccom- 
panied. If  she  tries  to  do  so,  she  is  at  once  seized 
with  a  spasm  of  most  agonizing  fear,  accompan- 
ied by  tachycardia,  dyspnoea,  cold  perspiration, 
vertigo  and  faintness,  and  the  idea  that  she  is 
about  to  have  a  stroke  of  apoplexy.  This  attack 
of  acute  fear  is  the  ** panic.'*  The  deterring  fear 
is  the  ^'phobia."  As  long  as  she  obeys  the  limi- 
tations imposed  by  the  phobia,  and  does  not  at- 
tempt to  venture  alone  beyond  certain  specified 
regions,  she  rarely  has  panics,  and  suffers  rela- 
tively little  active  fear. 

Another  woman  has  a  phobia  of  dogs,  thinking 
one  may  bite  her  and  she  will  have  hydrophobia. 
She  never  leaves  her  house  without  wondering 
anxiously  if  she  is  going  to  meet  a  dog.  If  she 
flees  one  approaching,  the  typical  panic  ensues. 
Whenever  possible  she  rides  in  cabs  in  order  to 
be  safe  against  the  animals.  If  she  goes  walk- 
ing with  her  husband,  she  insists  that  he  carry  a 
heavy  cane  in  order  to  protect  her.  The  mere 
mention  of  dogs,  particularly  if  anything  is  said 
about  their  going  mad  or  biting  any  one  makes 
her  very  nervous. 


432    MORBID  FEARS  AND  COMPULSIONS 

A  third  patient  has  a  phobia  of  knives.  If 
she  sees  a  sharp  knif e,  she  becomes  afraid  that 
she  may  use  it  to  injure  herself  or  some  other 
person.  She  cannot  go  into  a  batcher  shop,  a 
hardware  store  or  any  other  place  where  she  is 
likely  to  see  knives  or  other  sharp  instroments 
exposed*  She  will  not  be  left  alone  in  her  house 
until  she  is  assured  that  the  carving  knif e,  sds- 
sorsy  and  all  such  instruments  are  put  away  and 
locked  up  out  of  her  reach.  If  she  were  ever  left 
alone  in  a  room  with  an  open  pen  knife  lying  on  a 
table,  she  would  have  a  panic  at  once. 

The  three  special  features  of  anxj^  hysteria 

are  thfin  liie  Attafik  n^t^fy^ip.  th^<pholj)ia^  wl 

serves  to  keep  the  individual  awavfrom  auch  sit- 

/and  ££e  ideational  element — the  notion  of  what 
is  that  is  feared.    In  addition  to  these  typicaT" 

^-symptoms  ike  patient  also  suffers  in  varying  de- 
grees  from  minor  ones  such  as  restlessness,  in- 
digestion, flatulence,  insonmla,  depression,  etc. 
In  not  all  cases  are  the  symptoms  developed  to 
typical  phobia  formation  as  described  here,  but  in 
mild  ones  may  be  limited  to  a  diffuse  uneasiness 
or  anxiousness,  or  a  tendency  to  unreasoning 
worry.* 

1  Worry  is  often  spoken  of  as  a  cause  of  insomnia,  of  depres- 
sion, and  in  fact  of  almost  any  sort  of  psychoneurotic  state,  par- 
ticularly among  those  all  too  numerous  non*medical  writers  who 
flood  the  popular  magazines  with  shallow  articles  on  medical 
subjects.  "Don't  worry,"  they  glibly  advise,  "and  then  you  wont 
have  insomnia  or  depression  or  nervousness  or  whatever  it  is 
you  may  be  sulTering  from."  They  might  just  as  well  say: 
''Don't  have  insomnia,  and  then  you'll  sleep,"  or  *'Don't  have  de- 


MECHANISM  OF  PHOBIA 


433 


What  then  is  the  relation  of  the  typical  symp- 
toms to  the  processes  of  the  U^omj^i&IL^  ^^^ 
what  are  the  mechanisms  by  which  they  are 
formed?    The  fear,  the  impulse  to  ran  away  f ronf| 
fiomethmgy  is  conditroned^^  as  was  said  \)eioTe^  by  j 
*^  ^ailTlT^^^g  ^P  Qf  libido  which  threatens  to^break 

is  his  own  nnconsgiogs  gpmiftl  jigQuJggg.    Bnt  in 

j)lace  of  the  ideas  corresponding  to  these  impulses 

tnere  appear  m  nis  consciousness  some  substi- 

tute  ideas,  bearing,  to  be  sure,  a  certain  relation 

to  the  repressed  ones,  but  ^^nerallv  referrin^^ 

.  to  .sofflfi  PPgLsibJft.  gXJ;grnardanger.^  The  jnner 

menace  is  represented  through  projection  by  an 

outer  one,,  and,  by  iakmg  care  to  avoid  tnis  outer 

"one,  the  patient  is  really  attempting  to  escape 

from  a  part  of  himself.    The  essential  proce'sIS 

of  tJie  symptom  formation  is  that  of  a  displace-  | 

menT'or'tlie  anxiety  affects Ihlo^ 'which'tfie  te-  I 

pressed  libido  has  been  converted.  — i 

TThere  is  a  story  of  a  farmer  who,  when  driv- 
ing slowly  along  the  road  leading  to  the  town,  was 
met  by  a  neighbor  who  asked  him:  ''Well,  Gy, 
whar  ye  goin'f 

**I'm  a  goin'  down  to  the  village  to  get  drunk,*^ 
replied  Cyrus,  gloomily,  ''and,  Oosh,  how  I  dread 
itl'* 

pression  and  then  you'll  be  cheerful."  For,  generaUy  f^pealdng, 
'^vorry"  U  not  a  cause  of  the  neurotic  state,  but  a  symptom  of 
it.  The  Spr^y,  which  these  writers  would  regard  as  a  cause  of 
insomnia,  nervousness  and  so  on,  is  TeaJJj.A^saorUd^amaiMu  * 
which,  in  common  with  the  insomnia,  depression  and  other  symp- 
toms in  the  case,  results  primarily  from  conflicts^  resistances,  and 
a  dammingup  of  the  libido. 


434    MORBID  FEABS  AND  COMPULSIONS 

This  story  impresses  ns  as  fmmyy  for  we  are  not 
aocnstomed  to  think  of  people  loddog  with  dread 
upon  the  falfinment  of  their  own  wishes.  We 
should  he  tempted  to  say  to  the  farmer:  ^^Well, 
if  that's  the  way  yon  feel  abont  getting  dmnk,  why 
do  yon  do  itT  Yon  dont  have  to  get  dmnk  if  yon 
don't  want  to."  Yet  snch  a  remark  wonld  show 
a  lack  of  appreciation  of  the  situation.  For  Gy 
did  want  to  get  drunk.  On  the  other  hand  he 
wanted  to  avoid  it,  or  at  least  its  unpleasant  con- 
sequences. He  had  in  short,  two  perfectly  incom- 
patible wishes,  one  just  as  real  as  the  other.  His 
state  was  that  of  conflict — a  conflict  which  re- 
sembles those  that  cause  a  neurosis,  save  for  the 
fact  that  both  sides  of  it  were  conscious.  We 
are  not  accustomed  to  think  of  people  dreading 
the  fulfillment  of  their  wishes,  because  ordinarily 
when  there  is  a  conflict  between  two  conscious 
wishes,  we  cast  up  accounts  between  them,  and 
fulfilling  the  more  urgent  one,  tend  to  overlook 
the  fact  that  the  other  existed.  For  instance,  a 
man  sees  a  fine  looking  runabout  and  says :  '  *  My, 
I  want  a  car  like  that."  But  then,  when  he  has 
inquired  the  price  and  finds  it  to  be  two  or  three 
times  what  he  expected,  he  then  says,  ^^No,  I  dont 
want  iV*  just  as  if  the  wish  for  it  had  suddenly 
evaporated. 

The  wishes  which  give  rise  to  the  neurosis  are 
those  which Tjeliav;e  Just  as  the  farmer's  wish  to 
become  intoxicated.  They  persist  in  trying  to 
fulfill  themselves  in  total  disregard  of  all  possible 
unpleasant  consequences  of  this  f ul^Ilinent  and  of 
the  existence  of  other  wishes  incompatible  with 


I 


FEAB  AND  DESIBE  435 

their  beinir  fulfilled.    The  individual  fears  them 


-as  he-might  tear  BStt  companions  whose  demoral- 
izing influence  would  lead  him  into  forms  of  in- 
dulgence whose  consequences  would  not  be  a 
source  of  pleasure  but  of  pain. 

It  is  clear  that  if  the  farmer  had  no  objection 
to  getting  drunk,  or  to  the  consequences  of  so 
doing  (if  he  had  no  resistances  against  this  form 
of  wish  fulfillment)  his  desire  for  alcohol  would 
not  have  been  a  cause  of  ^  ^  dread. ' '  Let  us  imagine 
that  he  did  go  to  town  and  that  his  worst  fears 
were  realized,  that  his  getting  drunk  had  more 
painful  consequences  than  ever  before,  that  he 
was  robbed  of  a  large  sum  of  money,  got  into 
various  scrapes,  and  finally  landed  in  jail.  Let  us 
further  imagine  that  while  he  was  thus  incarcer- 
ated and  had  time  to  meditate  upon  his  sins,  an 
eloquent  preacher  visited  him,  and  not  only  suc- 
ceeded in  convincing  him  of  the  error  of  his  ways, 
but  converted  him  to  religion,  and  made  him  firmly 
and  sincerely  resolve  never  to  touch  alcohol  again. 
In  short,  let  us  suppose  that  his  resistances 
against  drinking  were  enormously  increased.  At 
the  same  time  we  shall  suppose  that  his  craving 
for  alcohol  (which,  to  make  the  point  clear,  we 
must  conceive  to  be  a  very  intense  one)  remained 
as  strong  as  ever  (as  it  very  well  might)  and  con- 
tinually assailed  and  tormented  him.  Under  such 
circumstances  as  these,  we  might  very  easily  con- 
ceive that  the  farmer  would  be  afraid  to  go  into 
saloons.  TUs  would  be  a  very  real  and  reason- 
able fear  caused  hy  desire. 

Now  let  us  go  further  and  imagine  that  through 


436    MOBBID  FEAES  AND  COMPULSIONS 

some  miracnlous  process  his  craving  for  drink  is 
transferred  from  consciousness  to  the  Uncon- 
scionSy  but  without  in  the  slightest  degree  dimin- 
ishing its  vigor.  The  desire  is  just  as  urgent  as 
ever^  though  the  farmer  no  longer  knows  that  it 
exists.  Under  such  circumstances  we  can  easily 
conceive  that  if  he  went  into  a  saloon,  say  to 
collect  a  billy  he  might  very  well  experience  a  sense 
of  uneasiness,  of  impending  evil,  of  fear,  ^DUhout 
being  aware  of  the  cause  of  this  fear,  since  the 
craving  on  which  it  depends  is  an  unconscious  one. 
Such  a  fear  would  be  just  like  those  which  exist  in 
anxiety  hysteria.  This  attack  of  fear  would  cor- 
respond to  the  panic. 

When  the  farmer  first  experiences  this  fear,  he 
says  to  himself:  ** What's  the  matter!  I  feel 
frightened.  Why  am  I  so  scared?"  He  cannot 
say  to  himself:  "You  are  afraid  you  will  break 
your  pledge,  and  get  drunk  again  and  shortly  go 
to  the  dogs,"  which  would  be  the  correct  explana- 
tion, because  his  desire  for  drink  is  now  an  un- 
conscious one,  and  to  get  drunk  is  the  very  last 
thing  in  the  world  he  ever  expects  again  to  do. 
Nevertheless  he  is  seeking  for  an  explanation  of 
his  fear.  We  will  suppose  that  at  this  point  he 
looks  up  and  sees  scowling  at  him  an  evil-looking,, 
blear-eyed,  ragged,  dirty  and  vIQainous  old  alco- 
holic who  is  leaning  against  the  bar.  Here  is  pre- 
sented an  opportunity  for  rationalization  of  the 
anxiety.  The  farmer  thinks:  ** Maybe  it's  that 
man  I'm  afraid  of.  He  looks  mean  enough  to 
murder  somebody.  Perhaps  he  is  planning  some 
harm  to  mel"    And  we  can  imagine  that  this 


FEAE  AND  DESIEE  437 

rationalization  is  accepted  as  the  true  explanation, 
particularly  as  the  evil  looking  alcoholic  might 
become  connected  in  the  farmer's  mind  with  the 
unconsdouB  desire  for  drink,  through  some  such 
train  of  thought  as :  ^  ^  There,  but  for  the  grace  of 
God,  stands  myself!''  In  this  way  what  is  really 
a  fear  of  drinking  could  become  what  appeared  to 
be  a  fear  of  evil  looking  men.  Then,  if  the  matter 
developed  along  the  lines  of  an  anxiety  hysteria, 
the  farmer  would  thereafter  have  panics  when  he 
found  other  villainous  looking  alcoholics  in  his 
vicinity,  for  they  would  serve  as  a  reminder  of 
hi^iy^lljljjj^and  he  would  develop  phobias  concem- 
m^piaoes  in  which  they  might  be  found.  Per- 
haps he  might  even  become  afraid  to  leave  home 
alone.  Yet  these  fears  would  at  the  same  time 
protect  him  against  the  real  cause  of  his  anxiety 
by  keeping  him  at  home  or  out  of  saloons  and  sim- 
ilar places  where  alcohol  as  well  as  evil  looking 
men  are  to  be  found.  This  feature  would  also  be 
very  much  like  what  often  happens  in  anxiety 
hysteria. 

This  may  all  seem  very  fanciful,  but  neverthe- 
less it  gives  a  good  picture  of  the  way  an  anxiety 
hysteria  develops.  The  essential  differences  are 
that  in  the  case  of  anxiety  hysteria  the  symptom- 
producing  wishes  belong  to  the  holophilic  im- 
pulses. (There  is  no  such  thing  as  unconscious 
desire  for  alcohol — ^rather  the  craving  for  alcohol 
itself  results  from  unconscious  desires,  and  sev- 
eral desires  instead  of  a  single  one  go  to  produce 
the  symptom.)  The  first  phase,  as  in  the  case  we 
have  imagined,  consists  in  the  appearance  of 


438    MOEBID  FEAES  AND  COMPULSIONS 


anxiety  without  the  individual  having  any  notion 
of  why  it  occurred  (a  phase,  by  the  way,  that  is 
generally  overlooked).  That  is  to  say,  scnne  of 
the  libido  of  the  wish-presenta^^^^ifi  frrftAlriTip 
throngfl  tne  repre^RiQTi>  la  draw^  off  as  anxie^ 
whUe  their  idea-content  rc^ynn^^"  ^^^1*^00/^1  ki 
the  next  discharge  of  this  energy  a  substitute  idea 
from  the  f oreconscious  is  found  which  serves  to 
rationalize  or  explain  the  anxiety,  and  at  the  same 
time  bears  some  associative  connection  with  the 
repressed  ideas,  just  as  the  farmer's  fear  of  vil- 
lainous alcoholics  connected  with  his  unconscious 
desire  for  drink.    The  ener^  of  the  wishes  escap- 

Jng  reprgflgion  ia  iil  other  words  dvit^lacpA  to  a 

substitute  idea,  which  ordinarilv  corresponds  to 
somVobjecCor  situation  in  the  externalworkL. 
Attacks  of  anxiety  may  then  be  brought  on  in  two 
"wayS^iie  by  aiimcreMfi  of  the  unconscious  libido 
tensionsapd the  otbiSS^'^itlmliii proceeding trom 

tne  i eared  object  fiorreBpoDf^JTig  fn  th^  anhatitntA 

^idea>^  The  feared  object  is  often  a  substitul 
kthe  sexual  object  toward  which  the  repressed 
wishes  are  striving.  Phobia  formations  then  de- 
velop and  tend  to  protect  more  and  more  against 
the  evoking  of  active  anxiety  by  prohibiting  the 
patient  from  approach  to  situations  in  which  stim- 
uli from  the  feared  object  or  condition  are  to  be 
received.    Naturally  even  if  the  patient  gives  in 

J  to  the  limitations  which  the  phobias  impose,  he  is 
not  totally  free  from  anxiety.  Flints  from  the 
external  stimuli  of  the  substitute  idea  have  no  in- 
fluence upon  those  attacks  of  anxiety  which  de- 


FEAB  AND  DESIBE  439 

velop  throngh  an  increase  of  the  libido  tensions 
within. 

Why  the  patient  is  absolutely  unable  to  reason 
away  these  fears  which  he  himself  knows  to  be 
foolish,  we  can  understand  if  we  imagine  our 
farmer  trying  to  dispel  his  fears  of  evil  looking 
men  by  carrying  a  revolver  to  protect  himself  from 
possible  attacks,  or  by  trying  to  assure  himself 
that  they  mean  no  harm  to  him  anyway.  These 
measures  have  no  effect  for  they  do  not  bear  at 
all  on  the  real  cause  of  the  fear.  A  revolver  is  no 
protection  against  getting  drunk  I  Those  meas- 
ures which  in  some  cases  do  have  some  effect  in 
reassuring  the  patient  against  his  fears  are  found 
on  analysis  to  have  a  definite  bearing  on  the  real 
cause  of  fear.  For  instance,  if  the  farmer  took 
some  righteous  person  with  him  whenever  he  went 
to  town,  with  the  consci(ms  idea  of  having  protec- 
tion against  the  attacks  of  evU  men,  this  person 
might  however  give  a  real  and  rational  sense  of 
security,  for  he  would  be  the  sort  to  prevent,  if  he 
could,  the  farmer  from  indulging  in  alcohol. 

It  may  be  said  that  morbid  fear  generally,  and  ( 
in  the  anxiety  neurosis  in  particular,  is  an  expres- 
sion of  the  essentially  passive  or  feminine  traitcr 
in  the  personality.  The  anxiety  neurosis  may 
then  be  considered  as  the  negative  of  the  maso- 
chistic perversion,  though  at  the  same  time  other 
perverse  tendencies  are  expressed  in  the  symp- 
toms. The  matter  of  pregenital  organization  or 
synthesis,  sudi  as  we  spoke  of  in  connection  with 
the  compulsion  neurosis,  has  not  been  as  well 
worked  out  for  the  hysterical  conditions. 


440    MORBID  PEAES  AND  COMPULSIONS 

To  supplement  what  has  been  said  as  to  the 
medhanisms  of  the  symptoms,  I  will  now  give  some 
brief  extracts  from  the  analysis  of  certain  fear 
symptoms  which  were  at  one  time  suffered  by  the 
patient  Stella,  whose  acquaintance  we  made  in  the 
preceding  chapter. 

Several  years  before  I  first  saw  her  she  began 
to  experience  a  marked  sense  of  fear  if  she  were 
left  alone  in  the  house.  She  felt  a  still  greater 
fear  of  having  to  pass  through  any  hallway  alone, 
and  if  she  were  compelled  to  do  so,  she  would 
ordinarily  have  an  intense  panic,  accompanied  by 
weakness,  tachycardia,  pallor  and  similar  symp- 
toms. It  was  not  until  I  had  known  of  these  fears 
for  some  time  that  she  told  me  that  in  the  panics 
she  had  the  idea  that  there  was  a  ghost  (a  '^dead 
soul")  coming  upon  her  from  hehmd  to  choke  her. 

She  had  panics  not  only  in  hallways  but  also 
when  she  went  to  the  toilet — ^unless  her  mother  or 
sister  stood  waiting  outside  the  door  aU  the  while 
Stella  was  within.  On  such  occasions  it  would 
seem  to  her  that  a  dead  soul  was  about  to  come 
out  at  her  from  the  hole  in  the  closet  seat.  I 
should  perhaps  say  that  Stella  never  really  be- 
lieved that  she  saw  any  of  these  ghosts,  and  was 
perfectly  well  aware  that  her  fears  were  utterly 
unreasonable  and  absurd. 

These  fears  were  expressions  of  anal-erotic  and 
birth  wish-phantasies.  A  hint  that  they  had  such 
origin  came  while  she  was  describing  a  particu- 
larly severe  attack.  She  was  leaving  a  certam 
house  at  night  and  had  passed  through  a  door  at 
the  bottom  of  the  stairway.    This  door  slammed 


FEAR  AND  DESIBE  441 

beliind  her  before  she  had  opened  the  outer  one. 
Thus  she  was  for  a  few  moments  shnt  in  the  entry- 
way  between  the  two  doors  as  if  in  a  very  smaU 
room.  Before  she  could  open  the  outer  door  and 
escape  to  the  street  she  was  seized  with  a  terrible 
fear  that  some  one  was  coming  through  the  hack 
(inner)  door  to  choke  her.  Concerni/ng  the  door 
in  front  of  her  she  felt  no  fear  whatever. 

Immediately  after  telling  me  this^  she  made  ai 
rather  suggestive  slip  of  speech.    She  was  speak- 1 
ing  in  German,  and  used  the  words  von  dem  Hwir  j 
terer  (from  the  behind^  i.  e.  the  gluteal  regions)/ 
when  she  had  intended  to  say  von  hint  em  (fromj 
behind).    After  this  she  told  me  that  she  felt  no 
particular  fear  when  alone  in  a  house,  so  long  as 
she  stayed  in  the  front  part.    She  recalled  at 
length  that  as  a  child  she  had  entertained  the  usual 
theory  that  children  are  bom  from  the  rectum. 
Also  she  reproduced  a  great  number  of  memories 
of  phantasies  of  anal  coitus,  wishes  for  which  she 
had  even  consciously  experienced,  at  least  momen- 1 
tarily,  during  most  of  her  married  life.    As  we  I 
already  know,  her  great  desire  for  children  was/ 
left  ungratified  through  the  sterility  of  her  husJ 
band.    These  wishes  for  children,  expressed  in  tha 
form  of  anal  birth  phantasies,  together  with  analj 
erotic  desires,  formed  the  basis  for  her  phobiasl 
Of  the  truth  of  this  statement  little  further  evi-1 
dence  is  required  than  that  furnished  by  a  record 
of  the  occurrence  of  her  attacks.    This  showed 
that  panics  appeared  when  she  found  herself  in 
any  situation  suggesting  hack  part,  hack  entrance, 
hack  opening  or  hack  passage. 


442    MOBBID  FEABS  AND  COMPULSIONS 

The  idea  of  the  ''dead  soul''  or  ghost,  which  was 
to  come  from  behind  to  choke  her,  has  the  follow- 
ing eiq>lanation.  The  analysis  revealed  it  as  a 
condensation  of  phantasies  of  rectal  coitus  and 
births  represented  by  a  fusion  of  certain  infantile 
sexual  theories.  An  early  notion  among  children 
is  sometimes  that  the  fertilizing  element  is  either 
flatus  or  breath.  This  ''vapor''  is  readily  identi- 
fied with  the  soul,  for  both  the  breath  and  the  soul 
leave  the  body  at  death.  But  the  souls  of  the  dead 
are  supposed  to  go  to  some  mysterious  region 
where  they  remain  for  a  time  and  then  return  to 
earth  as  a  new  bom  child.  In  this  way  the  ghost 
or  soul  of  a  dead  person  is  the  same  as  a  yet  un- 
born child.  And  when  we  alter  the  idea  in  Stella's 
fear  according  to  the  suggestion  afforded  by  her 
slip  of  speech — i.  e.  that  the  dead  soul  was  to  come 
not  so  much  from  behind  as  from  the  behind  (the 
anus),  it  is  evident  that  we  have  represented  a 
phantasy  of  birth  by  rectum.  The  toilet  seat, 
from  which  she  feared  a  ghost  would  come,  is 
easily  recognized  as  an  external  representative  or 
symbol  of  the  anus,  a  hole  into  which  feces  go  in 
place  of  one  from  which  they  come  out.  Choking, 
in  which  tiie  breath  or  soul  leases  the  body,  in  like 
manner  stands  for  conception,  in  which  a  new  soul 
enters  it.* 

What  Stella  really  was  afraid  of  was,  then,  her 
own  wishes  for  children,  and  for  what  amounted 

1  The  representatloii  of  an  idea  by  its  oppprite  ig  a  common  oe- 
currence  In  "ojWlpfnm' Qn.^.5^^**jLTn  fnrnfft^iOP—  ^*  *"  ^^  almtit  tJiA 
game  principle  that  a  N^gro  Is  ealled  ''SnowbaU"  or  a  fat  man 
nidmamed  "Skinny." 


FEAB  AND  DESIBE  443 

to  a  perverse  method  of  getting  them,  anal  coitnSi 
which  was  one  of  her  early  conceptions  of  the 
seznal  act.  Against  both  of  these  wishes  she  had 
strong  resistances.  Before  marriage,  to  have 
children  meant  to  sacrifice  her  virginity ;  after  it, 
to  be  unfaithful  to  her  husband.  Her  objections 
to  anal  intercourse  were  more  of  the  ssthetic  than 
of  the  moral  order.  Consequently,  in  place  of  the 
ideas  correctly  representing  these  wishes  there 
had  entered  her  consciousness  substitute  ideas 
which,  though  closely  resembling  the  repressed 
ones,  not  only  concealed  their  meaning  but  allowed 
the  developing  affects  to  be  referred  to  external 
situations  from  which  escape  could  be  made  by 
flight 


CHAPTEB  IX 

a  ga8e  of  anxiety  hystebia 
(thb  oasb  of  miss  sukdeblanb) 

THIS  patient  was  an  nnmarried  girl  of 
twenty,  bom  in  America.  At  the  time  she 
became  ill  she  was  employed  as  secretary 
to  a  business  man.  Her  previous  history  revealed 
nothing  of  importance.  Except  for  the  usual  dis- 
eases of  childhood  she  had  always  been  in  good 
health.  The  physician  who  referred  her  to  me,  a 
very  careful  internist,  reported  that  he  had 
examined  her  most  thoroughly  and  found  no  or- 
ganic trouble.  Neurological  examination  was  also 
negative. 

Her  nervous  illness  began  seven  or  eight  months 
before  she  came  to  me.  One  day  while  at  work 
she  was  suddenly  seized  with  a  sort  of  fainting 
attack,  which  came  on  without  any  apparent  cause. 
After  five  or  ten  minutes,  she  was  revived  through 
the  efforts  of  some  of  the  office  force  and  was  able 
to  go  home,  though  in  a  very  weak  and  nervous 
condition.  In  a  day  or  two  she  returned  to  work, 
but  within  the  three  weeks  following  she  had  two 
more  of  these  attacks.  The  seizures  were  not 
convulsive.  She  appeared  to  be  unconscious  dur- 
ing them,  but  her  loss  of  consciousness  was  not 
complete,  for  there  was  all  the  time  before  her 

444 


AN  ANXIETY  HYSTERIA  445 

mind  the  idea  that  she  was  dying,  that  her  end  had 
come. 

While  out  for  her  lunch  one  day  shortly  after 
her  third  experience,  she  was  suddenly  seized  with 
an  appalling  fear  of  being  alone.  The  idea  had 
stntbk  her  that  she  might  at  any  time  have  another 
fainting  attack,  in  which  she  would  die,  or  be  run 
over,  or  meet  with  some  other  serious  accident. 
This  fear  rapidly  became  so  much  worse  that  in  a 
short  time  she  was  unable  to  leave  her  home  alone, 
or  to  ride  on  the  subway  or  street  cars  even  if 
there  were  some  one  with  her.  Any  attempt  she 
made  to  go  out  unaccompanied  or  to  ride  in  a  pub- 
lic conveyance  nearly  always  resulted  in  her  de- 
veloping a  feeling  of  uncertainty  and  dizziness, 
with  such  an  intense  fear  of  falling  in  a  faint  and 
dying,  that  she  would  have  to  return  home  imme- 
diately. 

In  addition  to  these  panics  which  appeared  when 
she  attempted  to  leave  the  house,  attacks  of  fear 
occasionally  occurred  at  home,  though  what 
brought  them  on  or  what  she  feared  she  was 
usually  unable  to  say.  Much  of  the  time  she  was 
depressed  and  nervous.  She  slept  poorly,  and 
complained  of  palpitation  and  dizziness.  Her 
fear,  of  course,  had  made  it  impossible  for  her  to 
return  to  the  office  where  she  had  been  employed, 
so  when  I  first  saw  her  she  had  not  worked  for 
several  months.  A  vacation  in  the  country  and 
various  medical  and  dietetic  treatments  had  had 
no  effect  on  her  symptoms. 

The  medical  friend  who  sent  her  to  me  had  ex- 
plained to  the  girl  and  her  mother  that  hypnotic 


446    MOEBID  FEAES  AND  COMPULSIONS 

suggestion  might  be  of  benefit,  and  she  came  to 
me  to  have  it  tried.  At  the  first  interview,  as  I 
started  to  explain  to  her  something  about  sug- 
gestion, she  interrupted  me  by  saying  she  was 
very  much  afraid  of  that  sort  of  thing  and  that 
she  thought  she  might  die  if  she  were  hypnotized. 
I  attempted  to  reassure  her,  but  she  said,  ''Oh,  it 
is  a  spooky  thing!  It  is  like  this,"  (holding  her 
arms  above  her  head  and  waving  her  hands).  ''I 
am  terribly  afraid  of  it/'  After  some  more  dis- 
cussion she  and  her  mother  both  asked  if  I  could 
hypnotize  some  one  else  so  they  could  see  the  proc- 
ess ;  and  I  therefore  invited  them  to  come  to  the 
clinic  at  Cornell,  where  I  hypnotized  one  of  the 
patients  in  their  presence.  After  this  demon- 
stration. Miss  Sunderland  was  even  more  afraid 
than  at  first,  so  that  at  last  I  explained  to  her  that 
there  was  another  land  of  treatment  that  could  be 
used  in  her  case  if  she  wished  to  try  it,  namely, 
psychoanalysis.  She  promised  to  think  it  over 
and  in  a  week  or  so  had  decided  to  come  to  me. 

Before  the  treatment  was  begun  I  had  a  private 
talk  with  the  girl's  mother,  who  assured  me  that 
her  daughter  was  very  innocent-minded,  having 
been  brought  up  with  the  greatest  of  care  and 
shielded  from  all  knowledge  of  evil.  The  mother 
shrewdly  observed  that  the  girl  seemed  to  be 
afraid  of  men,  adding  that  there  was  a  very,  fine 
young  man  who  had  seriously  courted  her,  but  she 
seemed  to  dislike  him  and  always  appeared  un- 
happy and  ill  at  ease  in  his  presence. 

Another  and  rather  surprising  bit  of  informa- 
tion which  the  mother  furnished  was  that  the  girPs 


AN  ANXIETY  HYSTEEIA  447 

first  attack  occnrred  on  the  day  following  a  severe 

fright.    Miss  S had  been  walking  through  a 

lonely  street,  when  a  man  some  distance  behind  her 
suddenly  shouted,  and  waving  his  arms,  ran  after 
her.  She  was  very  much  frightened  and  tried  to 
run,  but  she  made  little  progress  for  her  legs 
seemed  heavy  and  she  felt  the  same  sense  of  inhi- 
bition or  paralysis  that  is  sometimes  experienced 
in  dreams.  At  any  rate,  the  man  who  apparently 
was  drunk  or  insane,  soon  gave  up  the  pursuit,  and 
the  girl  escaped  seemingly  none  the  worse  for  the 
incident,  until  there  occurred  the  next  day  the 
fainting  attack  with  which  her  illness  began. 

When  the  girl  came  to  me  for  the  visit  which 
began  the  analysis  her  mother  asked  her  in  my 
presence  if  she  had  told  me  about  this  fright.  The 
girl  replied,  "No,'*  and  when  she  and  I  retired  to 
my  office  she  seemed  rather  reluctant  to  speak 
about  it  and  did  so  only  after  a  little  urging.  As 
she  described  the  behavior  of  the  man,  I  was 
struck  by  the  fact  that  she  raised  her  arms  and 
waved  her  hands  with  exactly  the  same  gestures 
that  she  had  used  in  speaking  of  the  ^'spoohvness^* 
of  hypnotism. 

She  then  began  to  talk  about  the  girl  she  had 
seen  me  hypnotize  at  the  clinic,  saying  how  afraid 
she  would  be  to  undergo  anything  of  that  kind. 
Then  after  a  pause  she  asked,  '^Did  you  notice 
how  that  girl  looked  at  youf "  **No,''  I  replied, 
^  ^  what  do  you  mean  f    ^  ^  She  looked  as  if  she  were 

in  love  with  you,  '*  Miss  S replied  with  a  laugh. 

Miss  S then  with  apparent  irrelevance  began 

to  tell  me  that  her  brother  was  engaged  to  a  girl 


448    MORBID  FEABS  AND  COMPULSIONS 

she  disliked  very  mnch  and  tliat  she  hoped  fhey 
would  not  marry.  After  this  there  was  a  pause, 
and  then  she  langhed,  explaining  again  with  ap- 
parent irrelevance  that  there  had  come  to  her 
mind  the  recollection  of  how  her  sister,  a  very 
amusing  child  of  thirteen,  had  remarked  after  a 
certain  man  had  left  the  house,  ''Oh,  I  am  cra^ 
about  him!    I  could  love  him  to  death  I" 

Then  followed  a  still  longer  pause,  after  whidi 
the  patient  begged  me  to  tell  her  what  she  should 
talk  about.  I  replied,  of  course,  that  she  was  to 
tell  whatever  she  wished  me  to  know  about  herself. 
At  length  she  went  on  by  saying,  ''I  think  one  of 
the  things  that  made  me  nervous  was  reading  the 
newspapers.''  Bather  reluctantly  she  explained 
that,  some  weeks  before  her  first  fainting  attack, 
she  had  read  a  number  of  reports  in  regard  to  an 
investigation  of  white  slavery  which  was  then  go- 
ing on  and  that,  partly  through  the  reports  and 
partly  through  a  talk  with  a  girl  friend  she  had 
been  led  to  believe  that  all  young  men  were  in- 
fected with  ''bad  diseases/'  This,  she  said, 
troubled  her  a  good  deal.  She  felt  as  if  she 
wanted  to  have  nothing  to  do  with  men.  She  was 
afraid,  also,  to  touch  the  straps  in  the  subway,  or 
to  handle  money,  fearing  she  might  get  some  in- 
fection. She  added  that  a  young  man  in  the  office 
where  she  had  worked  (the  same  young  man,  I 
learned  later,  that  her  mother  had  referred  to)  had 
somewhat  hairy  hands  and  this  made  her  think  of  | 
dirt  and  infection  so  that  she  could  not  bear  the 
thought  of  touching  anything  he  had  touched  or 
even  of  being  in  his  presence.    She  added,  how- 


AN  ANXIETY  HYSTERIA  449 

ever,  that  while  this  man,  whom  we  may  call  Mr. 
Densmore,  had  everywhere  the  reputation  of  be- 
ing an  exceedingly  dean  and  straight  person,  this 
did  not  lessen  her  aversion  to  him. 

These  bits  of  inf  ormation,  which  I  have  re- 
corded, though  at  first  glance  seemingly  irrelevant 
and  disconnected,  are  when  carefuUy  examined, 
really  reducible  to  one  common  element  The 
girl  seemed  to  have  a  great  fear  of  hypnotism. 
Now  to  most  people,  hypnotism  means  to  be  under 
the  spell  of  another  person,  and  hence  it  is  a  fre- 
quent symbol  for  sex  attraction,  as  has  often  been 
shown  through  the  analysis  of  neurotic  symp- 
toms, dreams  and  the  delusions  of  the  insane. 
That  the  fear  of  hypnotism  in  this  case  had  such 
a  meaning  seemed  to  be  true,  inasmuch  as  the  pa- 
tient imagined  that  the  girl  I  had  hypnotized 
looked  as  if  she  were  in  love  with  me.  Then,  too. 
Miss  Sunderland  had  used  the  identical  gestures 
and  expressions  in  speaking  of  hypnotism  that 
she  had  later  used  in  describing  the  actions  of  the 
man  who  had  chased  her.  This  would  seem  to  indi- 
cate that  in  some  way  she  identified  hypnotism  or 
the  hypnotist  with  the  man  who  had  frightened  her. 
And  when  it  is  remembered  that  in  a  woman's 
fear  of  an  insane  or  drunken  man  there  is  usually, 
consciously  or  unconsciously,  some  thought  of  a 
possibility  of  sexual  violence,  it  would  seem  that 
the  sex  or  love  element  must  have  been  the  basis 
for  the  identification.  Again,  as  the  mother  had 
remarked,  the  girl  seemed  to  be  afraid  of  men  in 
general,  and  such  a  fear  upon  analysis  usually  is 
found  to  have  origin  in  a  sex  conflict. 


450    MOEBID  FEAES  AND  COMPULSIONS 

Farther,  the  girl  had  mentioned,  apparently 
apropos  of  nothing,  that  her  sister  had  confessed 
to  being  ^^ crazy"  about  some  man.  This  associa- 
tion can  be  explained  on  the  same  basis.  Patients 
who  do  not  want  to  talk  about  their  intimate  lives 
are  apt  to  talk  about  other  people  with  whom  they 
identify  themselves.    Hence  one  might  suppose 

that  the  reason  Miss  S spoke  of  her  sister 

was  because  of  an  identification  based  on  the  fact 
that  she  too  was,  in  some  degree  ^^ crazy"  about 
some  man,  or  was  likely  to  become  so. 

The  meaning  common  to  all  this  material  then, 
seems  to  be  that  the  girl  was  afraid  of  love  or  sex. 

We  could  suppose  certain  romantic  or  erotic  im- 
pulses had  begun  to  make  themselves  felt  within 
her,  but  that  she  was  trying  to  repress  them,  and 
in  consequence  they  were  distorted  so  as  to  be  per- 
ceived by  her  in  the  shape  of  fear,  instead  of  ap- 
pearing in  their  true  form. 

But  we  can  go  still  further.  Since  she  was 
afraid  she  would  die  if  hypnotized,  and  since  hyp- 
notism seemed  to  represent  some  sex  influence^  it 
would  appear  that  death  was  a  symbol  for  some 
result  of  sex  influence  both  in  this  case  and,  pre- 
sumably, also  in  connection  with  her  symptomatic 
fear  that  if  she  went  out  alone  she  might  fall  in  a 
faint  and  die.  As  Jung  has  remarked,  young  girls 
who  speak  of  death  think  of  love.* 

That  her  fear  of  infection  was  connected  with 
the  sex  problem,  is  obvious,  but  in  just  what  man- 
ner it  was  connected  will  become  more  apparent 
later. 

1  'a)iagii08tiBche  AasSziatioiiBBtudien/'  Bd.  I,  Bdtrag  Vm. 


AN  ANXIETY  HYSTERIA  451 

At  the  second  visit,  the  subject  of  dreams  came 

up,  and  Miss  S remembered  that  some  time 

earlier  she  had  had  a  dream  in  which  she  was 
being  pursued  by  a  Japanese  girl  and  from  which 
she  awoke  very  nervous  and  frightened.  Men- 
tion of  this  dream  will  be  made  later. 

For  several  succeeding  visits  our  talk  was  of 
more  or  less  superficial  things  and  revealed  little 
of  the  patient's  unconscious  processes.  I  learned 
that  her  family  were  very  religious;  that  her 
mother,  though  very  kindly  on  the  whole,  was 
somewhat  strict  and  puritanical;  and  that  her 
father  was  extremely  indulgent  and  affectionate. 
He  petted  and  made  a  great  fuss  ove^  her,  and  she 
was  devoted  to  him.    On  the  surface  at  least  Miss 

S and  her  mother  were  on  the  best  of  terms. 

Of  her  brother,  who  was  a  little  older  than  her- 
self, she  was  very  fond,  and  she  admitted  that  she 
was  displeased  and  somewhat  jealous  when  he 
began  to  pay  attentions  to  the  girl  to  whom  he 
eventually  became  engaged.  On  the  whole  the  pa- 
tient's  home  seemed  to  be  a  very  happy  one.  Mr. 
libby,  the  man  by  whom  she  had  been  employed, 
had  been  an  intimate  friend  of  the  family  for 
many  years ;  and,  though  not  actually  a  relative, 
he  had  behaved  as  one.  The  patient  was  a  great 
favorite  with  him ;  and,  as  he  was  very  wealthy,  he 
had  been  able  to  do  a  great  deal  for  her.  It  was  to 
gratify  a  whim  of  his,  rather  than  that  there  was 
any  need  of  her  working,  that  she  had  taken  a  posi- 
tion in  his  office. 

After  several  visits  the  patient  had  the  follow- 
ing dream :  She  was  struggling  with  a  large,  slim^ 


452    MORBID  FEARS  AND  COMPULSIONS 

long-nosed,  gray  dog,  which  was  trying  to  bite  her, 
while  she  endeavored  to  prevent  it  by  holding  his 
month  shnt  with  her  hands.  The  dog  finally  did 
bite  her  somewhere  in  the  thigh.  She  saw  a  little 
blood  flowing  from  the  wonnd,  and  then  her  body 
began  to  swell  np  to  a  great  size,  and  she  awoke 
terrified. 

This  is  evidently  a  sexnal  dream.  Its  symbol- 
ism is  very  typical.  Yonng  girls  are  apt  to  con- 
ceive of  sexuality  as  something  animal-like  and 
violent  When,  therefore,  a  girl  dreams  of  some 
violent  attack  or  assault,  one  can  feel  quite  as- 
sured that  what  she  has  in  mind  is  something  sex- 
ual And,  when  this  attack  results  in  the  shed- 
ding of  a  little  blood  and  is  followed  by  swelling 
of  the  body,  the  analogy  to  defloration  and  a  re- 
sulting pregnancy  is  so  striking  that  there  need 
be  little  doubt  as  to  what  the  dream  means.  In 
designating  the  thigh  as  the  point  attacked  the 
dream  employs  the  same  sjrmbolism  that  is  famil- 
iar from  the  Bible,  wherein  the  word  "thigh'*  is 
often  used  when  another  part  of  the  body  is  meant. 
Li  the  case  of  a  girl  who,  as  this  one,  had  been 
brought  up  in  "innocence''  and  taught  to  regard 
sexuality  as  something  sinful  and  dirty,  to  be 
avoided  and  feared,  it  is  quite  natural  that  dreams 
about  sex  should  be  accompanied  by  a  sense  of 
horror  and  fear  instead  of  pleasurable  emotions. 
Of  all  this,  of  course,  I  said  nothing  to  the  girl,  but 
simply  asked  her  to  give  associations  to  the  dream, 
without  in  the  least  intimating  that  I  suspected 
what  it  meant. 

Though  she  said  at  first  that  the  dream  brought 


AN  ANXIETY  HYSTEEIA  453 

nothing  to  her  mind,  after  a  little  urging  she  ad- 
mitted she  had  thought  of  something  which  she 
had  felt  ashamed  to  tell  me  because  it  had  to  do 
with  sex.  What  she  had  in  mind  was  this.  Up 
to  the  time  she  read  about  the  white  slave  investi- 
gations she  had  known  nothing  about  sex  and  had 
felt  no  curiosity.  ^  But  these  articles  aroused  her 
interest,  and  at  last  she  went  to  a  girl  friend  and 
asked  for  enlightenment.  This  girl  gave  with  no 
little  relish  a  description  more  vivid  than  accu- 
rate of  prostitution,  venereal  diseases,  the  abduc- 
tion of  girls,  and  other  matters  of  a  similar  char- 
acter.   The  chief  impressions  which  Miss  S 

derived  from  all  this  were  that  the  first  coitus  is  a 
very  terrible  and  bloody  affair,  in  which  a  girl 
screams,  faints,  or  even  dies  of  pain,  and  that, 
when  swayed  by  erotic  emotion,  men  are  little  if 
at  all  removed  from  savages  and  wild  beasts. 

Not  unnaturally.  Miss  S was  shocked  and 

frightened,  and  she  resolved  to  have  nothing  to 
do  with  men  as  long  as  she  lived.  At  the  same 
time,  she  had  some  dim  suspicion  perhaps  things 
were  not  quite  as  terrible  as  they  had  been  repre- 
sented to  her.    In  addition,  the  picture  of  the 

1  Before  this,  Bhe  said,  she  had  had  no  knowledge  of  aeznal 
relations  and  had  not  known  how  children  came  into  ezistenoe. 
In  fact,  when  she  was  nineteen  years  of  age  she  had  created  some 
commotion  by  asking  before  a  whole  roomful  of  people  why  It 
was  that  widows  did  not  have  children.  Knowing  in  a  vagne  way 
that  marriage  had  something  to  do  with  birth,  she  had  not  been 
able  to  understand  why  widows,  since  they  had  been  married, 
did  not  continue  to  reproduce.  She  said  she  was  not  sure  that 
ahe  had  known  at  that  time  that  babies  developed  in  the  body  of 
the  mother.  We  shall  see  later  that  the  patient's  ignorance  was 
not  as  profound  as  it  seemed. 


454    MORBID  FEABS  AND  COMPULSIONS 

sexual  act  which  her  friend  had  painted  had  a  cer- 
tain strange  fascination  for  her  and  kept  recur- 
ring to  her  mind  with  annoying  insistence  in  spite 
of  the  fact  that  she  felt  it  wrong  to  have  such 
thoughts  and  made  every  effort  to  banish  them. 

At  any  rate,  these  associations,  which  were 
brought  to  the  patient's  mind  by  the  idea  of  vio- 
lence,  blood,  etc,  in  her  dream,  show  plainly  her 
sado-masochistic  conception  of  sexuality,  and  con- 
firm my  conclusion  that  her  dream  could  be  inter- 
preted on  such  a  basis.  The  dog  in  the  dream 
may  be  regarded  as  a  symbol  for  a  sexually  ex- 
isted man,  for  as  shown  by  her  associations  she 
had  thought  of  men  under  such  drcumstanoes  as 
being  wild  animals.  The  shedding  of  blood,  the 
swelling  of  the  body,  etc,  are  details  which  com- 
plete the  phantasy  of  defloration  and  pregnancy. 

There  now  arises  the  question.  Who  is  the  man 

that   the   dog   represents?    Miss    S ^   when 

asked  for  associations  concerning  the  dog,  recalled 
that  on  the  evening  of  the  dream  some  young  peo- 
ple had  been  at  her  house.  She  had  shown  them  a 
set  of  snapshots,  among  which  was  a  picture  of 
herself  with  her  arms  around  a  large  dog.  The 
dog  in  the  picture,  however,  did  not  look  like  the 
one  in  the  dream. 

After  telling  me  this  the  girl  stopped  and  ssdd 
that  she  could  give  no  further  associations.  But 
when  I  insisted  that  there  must  be  something  in 
her  mind,  she  began  to  laugh  and  told  me  that  Mr. 
Densmore,  her  **pet  aversion,'*  who  was  among 
those  present  on  the  evening  of  the  dream,  had 


AN  ANXIETY  HYSTERIA  455 

said  when  he  beheld  the  picture  just  mentioned^ 
**MyI    How  I'd  Uke  to  be  that  dogl" 

Chir  question  as  to  whom  the  dog  in  the  dream 
represents  is  now  answered.  It  did  not  look  like 
the  one  in  the  picture,  but  was  slim,  gray,  and  had 
a  long  nose.  Mr.  Densmore  is  slim,  has  a  long 
nose,  and  on  the  evening  in  question  wore  a  gray 
suit  of  the  same  color  as  the  dog  in  the  dream. 
Thus,  the  dream  dog  is  a  composite  formed  by 
fusing  his  image  with  that  of  the  dog  in  the  pic- 
ture.   It  is  he  that  the  dog  represents. 

The  analysis  of  this  dream,  which  showed  it  to 

be  a  sexual  fantasy  with  Mr.  D as  its  object, 

on  the  one  hand  accords  with  the  suspicions  which 
have  already  arisen  that  the  source  of  the  young 
lady's  fear  was  the  sex  conflict;  but,  on  the  other, 
it  contradicts  certain  statements  she  had  made. 
She  had  repeatedly  asserted  that  she  had  disliked 

Mr.  D intensely.    If,  as  sometimes  happened, 

some  one  jokingly  accused  her  of  liking  him,  she 
took  the  greatest  pains  to  deny  the  accusation  in 
most  emphatic  terms  and  to  create  the  impression 
that  her  feeling  toward  him  was  one  of  boundless 
contempt  She  had  admitted  that  he  had  courted 
her  and  that  she  was  convinced  he  would  propose 
to  her  if  she  gave  him  the  least  encouragement. 
She  never  did  encourage  him,  however,  but,  on  the 
contrary,  treated  him  as  meanly  as  she  could,  tried 
to  avoid  him  whenever  possible,  and  spared  no 
pains  to  prevent  his  rare  visits  to  her  house.  All 
this  is  entirely  at  variance  with  what  the  dream 
seems  to  indicate,  namely  that  Mr.  D x>ossessed 


456    MORBID  FEARS  AND  COMPULSIONS 

a  strong  sexual  attraction  for  her.  Bat  we  can 
easily  interpret  her  aversion,  dislike,  etc,  as  cor- 
responding to  the  straggle  in  the  dream  against 
the  dog  and  to  her  efforts  to  hold  his  mouth  shut 
CTo  keep  his  mouth  shut"  equals  ''to  keep  him 
from  proposing.")  The  dream  thus  shows  two 
sides  of  the  patient's  personality,  a  concealed 
phase  upon  which  Mr.  D exerted  a  strong  sex- 
ual appeal,  and  the  conscious  phase  which  repelled 
it.  In  other  words  while  hardly  realizing  it,  she 
had  a  certain  wish  that  in  spite  of  her  protesta- 
tions he  would  continue  his  attentions  and  that  she 
might  eventually  marry  him,  have  sexual  relations 
with  him,  and  bear  his  children,  while  her  feelings 
of  dislike,  etc.,  were  really  an  overcompensation 
for  this  submerged  stream  of  feeling. 

In  the  light  of  all  this,  the  fears  from  which  fhe 
patient  suffered  can  be  interpreted  as  fears  of 
desire,  or  of  temptation.  Thus,  the  reason  she 
was  afraid  to  ride  on  the  subway,  etc.,  was  that,  if 
she  were  able  to  ride,  she  would  have  no  reason 
for  not  going  to  the  office,  where  she  would  see 

Mr.  D every  day — ^a  thing  which  she  thought 

would  result  in  her  eventually  accepting  him  and 
fulfilling  her  sexual  wishes.  Her  dislike  of  Mr. 
Densmore  and  her  fear  were  thus  designed  to 
serve  the  same  function  of  protecting  herself 
against  her  longing  for  him.  She  tried  to  dislike 
him  in  order  to  prevent  herself  from  Hking  him 
too  much,  or  in  a  way  that,  in  her  opinion,  was  not 
right. 

I  explained  the  dream  to  the  patient,  indicating 
what  wishes  it  seemed  to  fulfill  and  the  reasons  for 


AN  ANXIETY  HYSTEEIA  457 

my  condusionSy  though  without  attempting  to 
point  out  the  relation  of  these  wishes  to  her  symp- 
toms. (This,  by  the  way,  was  the  first  reference 
on  my  part  that  had  been  made  to  matters  of  sex«) 

She  replied  that  although  she  regarded  my  ex- 
planation of  the  dream  as  a  very  ingenious  and 
plausible  one,  it  was  entirely  wtong.    As  far  as 

Mr.  D was  concerned,  she  did  not  like  him, 

never  had  liked  him,  and  never  would.  In  addition 
to  this,  she  felt  that  it  was  depraved  and  sinful  to 
have  sexual  thoughts.  She  never  had  sexual  feel- 
ings and  never  expected  to  have  them;  her 
thoughts  were  always  pure.  She  admitted  that 
there  were  certain  older  men  she  had  liked  very 
much,  but  denied  that  in  this  liking  there  was  any- 
thing sexual.  I  did  not  argue  with  her  about 
these  matters,  but  preferred  to  wait,  feeling  sure 
that  sooner  or  later  something  would  come  up  to 
confirm  my  interpretations. 

After  this  the  girl  showed  an  increase  of  resist- 
ance, and  for  some  time  I  could  get  little  out  of 
her.  She  said  I  was  welcome  to  ask  her  any  ques- 
tions, but  there  was  nothing  more  she  could  tell 
me.  Of  course  I  explained  to  her  that  there  were 
no  questions  I  wanted  to  ask  and  that  the  only 
thing  expected  of  her  was  to  tell  what  thoughts 
came  to  her  mind,  even  if  they  did  not  appear  to 
be  of  any  great  significance.  She  insisted  that 
everything  had  been  told  and  that  nothing  more 
occurred  to  her.  At  last  I  explained  that  this 
seeming  absence  of  associations  came  about  ordi- 
narily when  the  patient  was  withholding  something 
of  which  she  was  clearly  conscious.    I  added  later 


458    MOBBID  FEAES  AND  COMPULSIONS 

that  this  something  not  uncommonly  proved  to  be 
the  recollection  of  some  definite  sexoal  experience. 
As  soon  as  I  made  this  remark,  I  saw  from  the 
girl's  expression  that  I  had  hit  upon  the  truth,  and 
I  told  her  so.  She  protested,  but  after  a  time  she 
suddenly  began  to  cry,  and,  saying  that  she  was 
very  miserable,  ashiuned,  and  unhappy,  begged 
me  not  to  ask  her  to  tell  any  more.  I  replied  that 
I  would  not  insist  on  her  telling  me  anything  she 
did  not  want  me  to  know,  but  asked  if  she  felt  she 
could  be  really  satisfied  not  to  tell,  now  she  had 
gone  this  far.  Finally,  after  imploring  me  not  to 
think  too  hardly  of  her,  she  related  the  following 
story. 

About  a  year  previous  to  her  illness,  she  formed 
a  friendship  with  a  girl  a  little  older  than  herself 
and  they  had  become  very  fond  of  each  other. 
The  older  girl  made  a  great  deal  of  her  and  petted 
and  kissed  her  continually,  all  of  which  she  had 
enjoyed.  At  length,  they  were  invited  to  spend 
a  night  at  the  house  of  a  friend,  where,  because 
there  were  other  guests,  it  was  necessary  for  the 
two  girls  to  sleep  together  in  the  same  bed.  After 
they  retired  they  lay  for  some  time  in  each  other's 
arms,  talking.  At  length  the  older  girl  became 
very  affectionate,  kissing  Miss  S — ^,  praising 
her  beauty,  stroking  her  face  and  arms,  and  press- 
ing their  bodies  together.    After  a  time  she  began 

to  stroke  Miss  S 's  thighs,  gradually  bringing 

her  hand  higher  and  higher  until  it  reached  the 
younger  girl's  genitals,  where  the  stroking  process 
continued.  Miss  S— —  lay  perfectly  still,  half 
pleased  and  half  frightened,  until,  when  she  began 


AN  ANXIETY  HTSTEEIA  459 

to  experience  sensations  of  an  munistakable  char- 
acter, she  suddenly  pushed  the  girl  from  her  in 
anger  and  shame,  protesting  that  they  could  never 
be  friends  or  see  each  other  again.  The  other 
girl  tried  to  apologize  and  make  up,  but  Miss 

S repulsed  all  these  attempts,  and  lay  awake 

the  rest  of  the  night  tormented  with  guilt  and 
humiliation.  The  next  morning  she  left  for  home 
as  early  as  possible,  and  strictly  avoided  the  other 
girl  thereafter.  * 

After  this  experience,  she  was  greatly  worried. 
Not  only  did  she  feel  that  she  had  committed  a  ter- 
rible sin  in  permitting  such  advances,  but,  when 
she  noticed,  on  one  occasion,  a  slight  leucorrhoeal 
discharge,  she  immediately  attributed  it  to  what 
had  occurred,  and  was  greatly  in  fear  that  she 
might  have  been  seriously  injured. 

Soon  after  she  heard  a  married  woman  of  her 
acquaintance  telling  about  a  Catholic  girl  who 
had  had  a  similar  experience.  The  priest,  this 
woman  said,  had  told  the  girl  that  such  occur- 
rences were  by  no  means  unheard  of,  and  that,  if 
she  was  truly  penitent,  nothing  further  was  re- 
quired of  her  than  to  forget  about  it.    Miss  S 

had  derived  some  comfort  from  this,  but  at  the 
same  time  had  never  ceased  to  reproach  herself. 
Of  course  I  assured  her  that  the  incident  was  of 
very  little  significance  and  she  need  feel  neither 
remorse  nor  alarm  about  it.* 

iThe  other  girl  looked  considerably  like  a  Japanese  and  was 
often  called  "Jap."    This  explains  the  dream  In  which  Miss  S 
was  chased  by  a  Japanese. 

s  One  usually  has  to  give  such  assurances  but  can  not  rely  upon 
than  to  remoTe  the  patient's  self-reproach  entirely^    If  the  emo- 


460    MORBID  FBABS  AND  COMPULSIONS 

At  the  next  vifiit  to  me  Miss  S said  that 

she  felt  better  and  that  she  was  glad  she  had  had 
the  courage  to  telL    At  the  same  time  she  re- 
proached herself  a  good  deal  and  still  seemed  to 
take  a  very  serious  view  of  what  she  had  done.    I 
told  her  that  such  an  experience  was  by  no  means 
unusual  among  girls — she  had  said  that  she  could 
not  believe  any  one  else  in  the  world  had  com- 
mitted that  sin — but  she  was  by  no  means  satisfied. 
In  succeeding  visits,  it  became  apparent  that  her 
remorse  though  partly  real  was  partly  an  exagger- 
ation.   She  was  serious  in  believing  that  she  had 
committed  a  great  sin,  but  at  the  same  time  she 
was  overremorseful  in  order  to  compensate  for 
the  fact  that  in  some  degree  the  experience  had 
been  pleasurable  and  to  assure  herself  that  any 
longing  for  its  repetition  was  absolutely  foreign 
to  her  thoughts. 

When  we  were  discussing  the  homosexual  expe- 
rience, I  took  occasion  to  tell  her  a  little  of  the 
significance  of  the  sex  instinct,  saying  that  the  im- 
pulse which  led  to  her  experience  was  primarily 
something  perfectly  normal  and  possessed  by 
everybody  and  that  the  only  thing  to  be  criticized 
in  her  case  was  that  it  had  been  misdirected.  I 
also  remarked  that  the  incident  showed  she  was 
not  so  entirely  devoid  of  a  sex  instinct  as  she  had 
claimed  at  the  time  of  the  analysis  of  the  dog 
dream.  ^ 

tioa  la  strong  it  is  dispelled  only  wlieii  the  patient  recalls  and 
connects  with  it  the  oorrective  experiences  of  childhood  oat  of 
which  arose  the  ego-ideal  specification  or  resistance  applying  to 
the  immediate  cause  of  the  sense  of  guilt. 

^  It  is  to  be  seen  that  the  resistances  which  began  when  ths 


AN  ANXIETY  HYSTEEIA  461 

In  connection  with  our  discussion  of  the  homo- 
sexnal  experience,  the  girl  remarked  that  ever 
since  it  she  had  felt  a  certain  resentment  toward 
lier  parents  for  not  warning  her  that  such  things 
conld  occur.    They  had  always  been  very  zealous, 
she  said,  in  cautioning  her  against  allowing  boys 
to  kiss  her  or  take  any  liberties  with  her,  and  these 
T^amings  she  had  heeded,  and  made  friends  only 
^th  girls.    Her  parents'  warnings  had,  she  felt, 
driven  her  from  one  danger  into  another,  and 
perhaps  worse  one,  where  she  had  least  expected 
it.    She  felt  she  had  been  rendered  over  suscep- 
tible to  the  possibility  of  homosexual  experience 
by  the  fact  that  she  had  been  led  by  her  parents  to 
so  carefully  avoid  the  heterosexual — ^a  reproach 
that  perhaps  is  not  entirely  without  foundation. 

She  continued  to  dwell  at  considerable  length  on 
how  profound  her  ignorance  of  sex  matters  had 
always  been,  until  at  last  I  remarked  that  such 
absolute  innocence,  as,  for  example,  she  had 
seemed  to  display  by  her  question  of  why  widows 
did  not  have  children,  was  usually  more  appar- 
ent than  real.  A  person  of  normal  intelligence 
living  in  our  environment  would  not  reach  the  age 
of  nineteen  or  more  without  divining  more  of  sex 
matters  than  she  had  seemed  to  know,  unless  there 
had  been  produced  by  repression  an  inhibition  of 
the  thought  process  and  an  artificial  blindness  to 

dream  was  analyzed  were  connected  with  the  homosexual  ezperi« 
ence.  The  mention  made  of  sex  matter  in  connection  with  the 
dream  of  course  brought  to  her  mind  the  homosexual  episode  and 
made  her  afraid  either  that  she  would  have  to  tell  about  it  or 
that  in  some  way  I  might  find  it  out.  The  result  was  that  for 
the  time  being  her  associations  were  blocked. 


462    MOEBID  FEAES  AND  COMPULSIONS 

thingis  sexual.  In  other  words,  such  apparent  ig« 
norance  as  hers  ordinarily  denoted  not  a  real  ig- 
norance of  sex  matters  but  rather  an  early  ao- 
quaintance  of  some  sort  with  them  which  was  suc- 
ceeded by  a  later  repression. 

After  a  time  she  admitted  that  perhaps  there 
was  some  truth  in  what  I  said,  for  she  suddenly 
remembered  that  when  she  was  about  thirteen 
another  girl  had  told  her  about  intercourse,  ex- 
plaining that  such  was  the  way  babies  were  made. 
She  could  not  believe  what  this  girl  told  her,  say- 
ing that  she  was  sure  her  parents  would  never  do 
such  a  dirty  thing.  The  next  day  this  girl  told 
of  her  reply  to  a  number  of  otiier  girls,  who 
laughed  so  heartily  over  the  patient's  innocence 
that  she  became  convinced  that  what  she  had  heard 
was  the  truth.  She  felt  shocked  and  frightened 
that  such  a  thing  had  taken  place  between  her  pa- 
rents and  thought  them  very  hypocritical  and  dis- 
honest to  have  kept  up  a  front  of  smug  morality 
and  virtue  when  all  the  time  such  awful  things 
were  going  on.  These  reflections,  however,  she 
had  put  out  of  mind ;  and  now,  as  she  looked  ba<^ 
upon  the  matter,  it  seemed  as  if  she  had  for  a  long 
time  really  succeeded  in  forgetting  what  she  had 
been  told. 

Shortly  after  this  visit  she  had  a  dream  in  whidi 
she  was  a  little  girl  and  she  lifted  her  skirts  and 
urinated  on  the  ground.  This  dream  led  her  to 
remark  that  at  five  or  six  years  of  age  she  had  had 
scarlet  fever,  which  resulted  in  ** kidney  trouble." 
Upon  questioning  her  I  found  that  what  she  had 
meant  by  kidney  trouble  was  really  nocturnal  enu- 


AN  ANXIETY  HYSTEBIA  463 

resiSy  a  condition  which  had  lasted  for  a  year  or 
more. 

This  bed  wetting,  since  it  came  on  so  late,  was 
in  all  probability  a  pollution-equivalent  and  con- 
neoted  with  masturbation.  Her  connecting  it  with 
kidney  trouble  as  a  sequel  to  scarlet  fever  was  a 
memory  condensation  serving  to  conceal  the  true 
nature  of  the  condition. 

The  homosexual  incident  shows  that  the  patient 
was  not  so  utterly  devoid  of  a  sex  impulse  as  at  the 
time  of  the  dog  dream  she  had  maintained,  and  the 
later  recollection  just  narrated  proved  that  she 
was  equally  incorrect  with  regard  to  her  state- 
ment of  absolute  ignorance  of  sex  matters,  for  she 
did  have  some  knowledge  of  things  sexual  even 
from  her  early  childhood.  It  may  be  noted  inci- 
dentally, that  in  these  early  ideas  the  sexual  was 
associated  with  the  excretory  processes,  a  fact, 
which  together  with  the  attitude  of  the  parents 
toward  sex,  had  to  do  with  her  strong  feeling  that 
the  sexual  was  essentially  **  dirty. '^ 

In  spite  of  the  fact  that  the  material  just  pre- 
sented was  contradictory  to  the  statements  made 
by  the  patient  at  the  time  of  the  dog  dream,  she 
was  no  more  ready  to  accept  my  interpretation  of 
it  than  she  had  been  in  the  first  place,  and  no  es- 
sential change  was  produced  in  her  attitude  to- 
ward it.  Fortunately,  more  corroborative  mate- 
rial was  not  long  in  forth  coming. 

I  was  expecting  that  after  the  homosexual  ex- 
perience had  been  discussed,  the  analysis  would 
progress  smoothly  for  a  while,  but  instead  the  pa- 
tient began  to  show  resistances  of  a  new  type. 


464    MORBID  PEABS  AND  COMPULSIONS 

She  talked  enough,  to  be  sure,  but  what  she  said 
was  obviously  intended  to  be  meaningless  and  mis- 
leading. She  laughed  a  great  deal  and  made 
many  silly  remarks.  She  showed  a  tendency  to 
belittle  everything  I  said,  to  be  derisive  and  sar- 
castic, and  to  make  fun  of  me.  The  motive  for 
this  soon  became  apparent,  and  in  the  following 
way. 

Jn  the  early  part  of  one  visit,  the  patient  spoke 
of  a  man  much  older  than  herself,  whom  she  had 
mentioned  on  other  occasions,  and  related  that  on 
the  preceding  evening,  when  she  was  at  a  theater 
party,  he  had  b^ged  for  one  of  the  flowers  she 
wore  but  she  was  embarrassed  and  refused  to  give 
it  to  him.    I  noticed  perhaps  half  an  hour  later 
that  while  we  talked  she  was  folding  her  hand- 
kerchief in  some  peculiar  shape.    As  soon  as  she 
saw  me  watching  her  she  laughed  and  covered  the 
handkerchief  wifluher  hands.    **What  were  you 
doing f  I  asked.    ^^I  was  making  a  flower,''  she 
replied.    ^^And  what  had  you  in  mindf  I  con- 
tinued.   She  seemed  embarrassed^  but  at  last  said, 
**I  thought  if  it  was  a  real  flower  I  would  like  to 
give  it  to  you.''    ** Flowers  are  sometimes  sym- 
bolic," I  said  at  last  (I  had  never  told  her  what 
they  symbolized).    "Is  it  possible  the  flower  rep- 
resents something  elsef    What  comes  to  your 
mindt"    **Nothing,"  she  replied;  "I  don't  think 
of  anythiQg — except,  perhaps,  the  lamp  on  your 
desk."    (Lamp  is  often  a  penis  symboL)    "Are 
you   sure   that   is   all?"    "Yes,"   she   replied; 
but  after  a  pause  she  suddenly  said,  "I  have 
thought  sometimes  I  would  like  to  give  you  a  kiss." 


AN  ANXIETY  HYSTERIA  465 

I  felt  that  the  flower  had  possibly  symbolized  even 
more  than  a  kiss^  but  thought  it  unwise  to  press 
the  matter  then;  and  the  sitting  ended.  At  the 
door  just  as  she  was  leaving  she  said,  ^^I  was  fool- 
ing ;  I  didn't  mean  what  I  said.  I  would  not  want 
to  kiss  an  old  married  man.'' 

At  the  next  visit  she  reported  that  she  had  felt 
quite  badly  during  the  two  days  that  had  inter- 
vened. As  she  was  going  up  the  stairs  on  reach- 
ing home  from  the  last  visit  she  had  felt  a  pain  in 
her  hearty  and  this,  with  occasional  dyspnoea,  had 
persisted  ever  since.  She  had  been  very  much 
frightened,  fearing  she  had  heart  disease  and 
might  drop  dead  any  instant.  She  had  been  very 
much  afraid  to  make  the  next  trip  to  my  office, 
thinking  she  would  die  on  the  way ;  and  she  would 
have  telephoned  to  break  the  appointment  had  not 
her  mother  insisted  upon  her  coming. 

The  same  night  this  pain  began  she  awoke  from 
her  sleep  saying  over  to  herself,  '^And  then  we 
went  to  Asheville,  but  my  cousin  was  there;  and 
then  to  Palm  Beach,  but  my  sister  was  there,"  and 
possibly  some  other  words  that  she  could  not  re- 
member. This  dream,  if  it  may  be  so  called,  has 
the  following  explanation.    A  few  days  before. 

Miss  S happened  to  meet  a  girl  of  her  sl(^ 

quaintance  who  had  recently  married,  having 
eloped  with  a  doctor.  It  seems  that  the  eloping 
couple  had  wished  to  keep  their  marriage  a  secret 
until  they  had  heard  from  the  bride 's  parents,  to 
whom  they  had  telegraphed  the  news.  The  young 
woman  gave  an  excited  description  of  their  diffi- 
culties, for  there  was  some  relative  or  acquaint- 


466    MORBID  FEAKS  AND  COMPULSIONS 

ance  at  nearly  every  place  they  went,  on  acoonnt 
of  which  they  had  to  keep  moving.  In  speaking  of 
this  the  yonng  wife  had  used  the  same  words  the 
patient  was  saying  over  to  herself  in  the  dream. 

The  dream  words  can  easily  be  interpreted  as  a 

part  of  a  wish-phantasy  in  which  Miss  S has 

an  experience  similar  to  that  of  the  yonng  bride,  a 
phantasy,  in  other  words,  that  she  had  ran  away 
with  a  doctor.  The  dream,  then,  is  a  continuation 
of  the  same  trend  which  was  responsible  for  the 
incident  of  the  flower  and  for  the  wish  to  give  me 
a  kiss.  All  of  these  were  transference  phenom- 
ena. The  heart  symptoms  and  the  anxiety  which 
accompanied  them  belong  in  the  same  categ^ory. 
She  had  begun  to  think  that  she  was  developing  a 
sentimental  affection  of  the  heart  with  regard  to 
me,  but  this  somewhat  alarming  reflection  was 
substituted  through  conversion  by  what  appeared 
to  be  an  organic  affection  of  the  heart. 

I  explained  to  Miss  S my  interpretation  of 

the  dream  and  also  of  the  heart  symptoms.  She 
laughed  very  heartily  at  both  but  admitted  I  was 
right.  (The  heart  symptoms  disappeared  imme- 
diately after  the  explanation.) 

She  then  confessed  that  she  had  entertained 
some  more  or  less  sentimental  thoughts  concern- 
ing me  almost  from  the  very  first,  adding  that  she 
had  not  known  for  certain  that  I  was  married  un- 
til the  time  of  the  last  visit.  She  had  been  afraid 
to  ask  her  mother  or  me  for  fear  it  would  look  as 
if  she  were  **too  interested.'*  But  on  that  oc- 
casion she  had  said  ^^I  would  not  want  to  kiss  an 
old  married  man"  as  a  way  to  make  me  commit 


AN  ANXIETY  HYSTEEIA  467 

myself  withoat  her  having  to  ask  a  direct  questioiL 
When,  from  the  way  I  replied,  she  saw  that  I  was  - 
married,  she  felt  considerably  perturbed  over  the 
fact  that  she  had  allowed  herself  to  get  into  such 
a  state  of  mind  concerning  me.    She  felt  it  wrong 
to  have  such  thoughts  about  a  man  who  was  mar- 
ried though  as  long  as  she  had  not  known  for  cer- 
tain that  I  was  married  she  had  not  particularly 
reproached  herself.    The  belief  that  such  things 
were  wrong  gave  rise  to  a  resistance  which  caused 
what  had  been  a  normal  expression  of  the  libido 
to  be  transformed  into  heart  symptoms  and  anxi- 
ety. 

The  discovery  of  the  existence  of  this  transfer- 
ence to  me  now  explains  why  the  patient  had  dis- 
played a  desire  to  belittle  and  make  fun  of  me. 
This  impulse  was  a  reaction  against  her  senti- 
mental interest,  and  was  intended  to  conceal  it. 

These  and  otiier  transference  phenomena  which 
manifested  themselves  in  immediately  succeed- 
ing visits  were  just  the  material  I  needed  to  cor- 
roborate my  analysis  of  the  dog  dream  and  my  ex- 
planation of  her  symptoms  derived  from  that 
analysis.  As  I  explained  to  her,  the  sentimental 
feelings  she  had  had  toward  me  were  not  new  and 
did  not  refer  to  me  actually,  but  represented  a 
transference  and  re-edition  of  feelings,  perhaps 
more  intense  originally,  that  she  had  had  to- 
ward some  one  else  without  being  willing  to 
realize  them.  In  other  words,  what  was  now  tak- 
ing place  con$ci(yusly  with  regard  to  me,  had  pre- 
viously taken  place  xmconsciously  in  regard  to 
some  other  person  who  for  the  time  being  I  rep- 


468    MORBID  FEARS  AND  COMPULSIONS 

resented.  This  person  I  was  quite  disposed  to 
think  was  Mr.  Densmore.  She  could  no  longer 
deny  that  she  was  capable  of  sentimental  feelings, 
because  she  had  had  them  toward  me ;  while,  since 
she  had  had  them  toward  me,  it  was  probable  they 
had  also  occurred  elsewhere,  even  admitting  that 
she  might  not  have  been  aware  of  thenu  Her  ap- 
parent detestation  of  Mr.  Densmore,  was,  I 
thought,  analogous  to  her  impulse  to  belittle  me. 
Her  heart  symptoms  and  the  fear  associated  with 
them,  that  she  would  die — a  fear  which,  if  she  had 
had  her  own  way,  would  have  prevented  her  from 
coming  to  my  office,  served,  obviously  enough,  as  a 
protection  against  developing  sentimentality  and 
expressed  her  wish  not  to  see  me  in  order  to  get 
over  any  interest  in  me.  They  were  in  perfect  an- 
alogy with  her  fear  of  riding  on  cars  and  of  going 
out  alone,  which  had  prevented  her  from  reaching 

the  office,  where  she  would  see  Mr.  D daily. 

In  short,  her  reactions  of  interest,  compensatory 
disparagement,  and  defensive  fear  symptoms  in- 
tended to  protect  again  an  increase  of  interest  by 
preventing  her  from  seeing  me,  gave  in  miniature 
a  view  of  the  reactions  that  had  taken  place  with 
greater  intensity  and  extent  in  respect  to  Mr. 
Densmore. 
But  here  again,  as  in  reference  to  the  dog  dream, 

Miss  S J  though  admitting  the  plausibility  of 

my  explanations,  was  by  no  means  convinced  by 
them.  She  protested  that  she  had  always  disliked 
Mr.  D and  could  not  believe  that  either  con- 
sciously or  unconsciously  she  had  ever  experienced 
toward  him  any  sentiments  of  a  more  tender  sort 


AN  ANXIETY  HYSTERIA  469 

But,  finally,  after  much  hesitation  she  stated  that 
one  day,  perhaps  a  year  before  the  beginning  of 
her  iUness,  she  was  with  him  in  a  crowded  subway 
train  and,  when  to  steady  her  he  put  his  hand  on 
her  arm,  she  experienced  a  sudden  flash  of  intense 
sexual  feeling.  This  sort  of  feeling,  she  acknowl- 
edged, had  frightened  her,  for  she  thought  such 
emotions  depraved  and  sinfuL  She  would  not 
admit,  however,  that  it  was  her  objection  to  such 
feelings  that  prevented  her  from  having  them  more 
frequently,  stubbornly  maintaining  that  it  was  not 
that  she  was  repressing  such  a  tendency  but  that 
the  tendency  did  not  exist.  She  did  admit  that 
after  the  incident  of  the  subway  her  resistances 

against  Mr.  D had  decidedly  increased,  but  she 

refused  to  see  that  they  were  intended  as  a  defense 

against  an  increase  of  sex  interest  in  him. 

.   During  the  period  this  discussion  was  going  on 

Miss  S opened  the  conversation  at  one  of  her 

visits  with  the  laughing  remark  ^^I  have  made  a 
new  transference;  you  are  not  in  it  any  more." 
She  went  on  to  explain  ihat  there  was  a  young 
doctor  who  had  paid  her  some  attention  of  late 
and  on  the  Saturday  night  preceding  this  visit 
she  had  attended  a  dance  where  he  was  present. 
He  danced  with  her  a  number  of  times,  held  her 
quite  dose,  and  gently  squeezed  her  hand  while 
they  were  dancing.  Toward  the  close  of  the  eve- 
ning he  took  her  to  a  side  room  which  happened  to 
be  empty  and  in  a  very  gentle  and  tender  way  put 
his  arms  around  her  and  kissed  her.  She  had 
been  quite  well  aware  of  what  was  coming  when  he 
jtook  her  to  this  room,  and  submitted  to  the  caress 


470    MORBID  FEABS  AND  COMPULSIONS 

with  very  little  protest.  On  the  whole  she  quite 
enjoyed  the  experience.  She  liad  expected  to  feel 
a  little  more  thrill  in  response  to  the  caress  than 
actually  took  place,  and,  though  a  little  disap- 
pointed in  this  respect,  she  viewed  the  experience 
as  a  very  pleasurable  one.  She  found  herself 
afterward  thinking  about  it  and  about  the  doctor 
with  considerable  sentimental  interest. 

This  affair  with  the  doctor  continued.    Miss 

S displayed  an  increasing  interest  in  him,  had 

many  daydreams  about  him,  and  allowed  him  to 
kiss  her  occasionaUy.  His  kisses  were  of  a  tender 
sort  and  gave  no  evidence  of  passion*    Miss 

S 's  feelings  seemed  to  correspond  to  his.    She 

liked  him  and  his  attentions,  but  neither  actually 
nor  in  her  daydreams  did  she  experience  any  feel- 
ings that  were  definitely  sexual  in  the  popular 
sense.  This,  she  said,  was  just  the  way  she  wanted 
things  to  be.  She  asserted  that  if  she  had  had  any 
physical  sex  sensations,  she  would  have  felt  so 
guilty  that  she  would  have  had  to  stop  seeing  him. 
Even  as  it  was  she  felt  a  little  guilty  about  allow- 
ing herself  to  be  kissed. 

About  this  time  the  analysis  was  interrupted  for 
a  considerable  period  because  of  my  absence  from 

the  city.    Miss  S had  improved  a  good  deaL 

She  could  not  go  out  alone  yet,  but  could  ride  on  the 
cars  if  there  was  some  one  with  her,  which  as  a 
rule,  she  had  not  been  able  to  do  before.  She  was 
almost  free  from  the  anxiety  attacks,  g^ieral  nerv- 
ousness, and  depression  from  which  she  had  pre- 
viously suffered  even  when  she  did  not  go  out 
For  about  a  month  after  I  left  she  kept  what  she 


AN  ANXIETY  HYSTERIA  471 

Had  gained,  and  then  she  got  worse  again.    I 
learned  after  the  analysis  was  resumed  that  this 
xelapse  had  taken  place  when  her  friend  the  doc- 
tor left  New  York  under  circumstances  that  led  her 
to  believe  that  he  was  not  likely  to  return.    Until 
the  analysis  was  resumed,  she  remained  in  about 
the  same  condition.    At  no  time,  however,  were 
her  symptoms  as  bad  as  when  she  first  came  to  me. 
Her  friendship  with  the  doctor  quite  obviously 
had  been  a  factor  in  her  temporary  improvement. 
He  was  a  sort  of  compromise  between  Mr.  Dens- 
more  and  me.    He  resembled  me  in  being  a  doctor 
and  Mr.  Densmore  in  that  he  was  not  much  older 
than  the  patient.    Her  feelings  toward  him  were 
not  sufficiently  ** physical* '  for  her  to  object  to 
them  and  for  this  reason  he  represented  an  emo- 
tional outlet  which,  while  she  had  it,  made  easier 
the  suppression  of  any  love  feelings  toward  Mr. 
Densmore  or  me.    In  a  sense,  it  was  a  case  of 
simiUa  simUibtis  curantur.    By  encouraging  her- 
self to  take  an  interest  in  the  young  doctor  she  at- 
tempted to  cure  herself  of  the  attraction  Mr.  D 

exerted  upon  her,  one  motive  for  so  doing  being 
her  reluctance  to  admit  the  definitely  sexual  feel- 
ings that  Mr.  D seemed  able  to  inspire  in  her  in 

spite  of  her  resistances.  But  when  the  safety 
valve  represented  by  her  friendship  with  the  doc- 
tor was  closed  by  his  leaving  New  York,  her  libido, 
thus  dammed  up,  reverted  to  its  earlier  channels, 

namely  to  Mr.  D and  myself.    By  getting 

worse  she  restored  her  defense  against  Mr.  D 

and  at  the  same  time  had  a  reason  for  continuing 
under  my  care. 


472    MORBID  FEARS  AND  COMPULSIONS 

All  this  was  explained  to  her  when  the  analysis 
was  resumed;  and,  though  she  said  she  could  not 
believe  it  to  be  entirely  true,  she  gave  the  impres- 
sion  that  dhe  was  more  nearly  convinced  than  she 
would  admit.  The  analysis  then  continued  for 
some  little  time  without  much  real  progress,  al- 
though she  had  immediately  improved  a  little  as 
soon  as  the  treatment  was  resumed— obviously  a 

transference  phenomenon.    Then  Miss  S had 

the  following  dream,  which  shows  a  reason  for  the 
standstill  and  at  the  same  time  discloses  a  piece 
of  new  information  about  the  factors  whidi  had 
operated  to  produce  her  neurosis.  This  is  her 
dream. 

'^I  was  ridiog  on  a  train  or  subway  oar.  A  fat 
man  who  sat  near  me  dropped  something  and  or- 
dered me  to  pick  it  up  for  him.  I  resented  being 
asked  to  wait  on  him  and,  seeing  a  key  on  the  floor, 
I  picked  that  up,  with  the  thought  that  instead  of 
doing  what  he  wanted  I  was  doing  just  the  oppo- 
site. Then,  I  ran  and,  getting  off  the  train,  hid  in 
a  house  to  get  away  from  him.  After  a  time  the 
scene  changed,  and  it  seemed  that  I  had  started 
out  to  enlist  in  the  German  Army.  Finally,  I 
found  myself  in  an  office,  where  sat  a  man  who 
seemed  to  be  a  priest,  but  was  also  Eong  James  IL 
The  man  said,  ^Tell  me  about  the  key,'  and  I  be- 
gan to  do  so.  He  listened  with  great  interest,  but 
he  kept  having  to  answer  the  telephone,  and  other 
interruptions  occurred,  ^so  that  the  dream  ended 
with  my  story  unfinished.'' 

This  dream  is  too  long  to  be  interpreted  here 
in  all  its  details.    I  shall  tell  only  the  most  import- 


AN  ANXIETY  HYSTERIA  473 

ant  of  the  patient's  associations  to  each  element 
of  the  dream,  and  explain  them  without  taking  up 
all  the  reasons  upon  which  the  explanation  is 
based. 

The  first  thought  in  the  dream,  ''I  was  riding 
on  a  train, ' '  led  the  patient  to  remark :  ^  ^  Well,  that 
is  just  what  I  cannot  do  now."  We  may,  there- 
fore, regard  the  fantasy  '^I  was  riding  on  the 
train"  as  the  equivalent  of  the  thought  ** Before  I 
was  taken  sick" — ^thus,  a  sort  of  subordinate  time- 
clause,  which  introduces  the  main  part  of  the 
dream. 

The  fat  man  in  the  dream  proved  to  be  the  pati- 
ent's  employer,  who,  in  fact,  is  very  stout.  His 
dropping  something  and  asking  her  to  pick  it  up 
and  her  resentment  at  this  request  have  the  fol- 
lowing explanation. 

Soon  after  she  began  to  work  for  him,  she 
had  reasons  to  be  not  altogether  satisfied  with 
the  step  she  had  taken.  For,  though  outside  of 
office  hours  her  employer  maintained  his  usual 
attitude  of  thoughtfulness  and  consideration,  yet 
in  the  office  he  treated  her  like  any  ordinary  sten- 
ographer,— ordered  her  around,  scolded  her  for 
mistakes,  swore  in  her  presence,  and  heaped  an 
enormous  quantity  of  work  upon  her.  This  made 
her  both  unhappy  and  resentful,  and,  had  it  not 
been  for  the  fear  of  hurting  his  feelings  and  the 
danger  of  the  considerable  materia}  loss  that 
ndght  result  if  she  incurred  his  displeasure,  she 
would  gladly  have  given  up  her  position.  In  fact 
if  anything  had  presented  itself  which  would  have 
furnished  a  good  excuse  for  her  leaving  his  em- 


474    MORBID  PEAKS  AND  COMPULSIONS 

ploy,  she  would  have  been  happy  to  take  advan- 
tage of  it  The  inconsiderate  attitude  of  her  em- 
ployer during  business  hours  and  her  consequent 
resentment  are  expressed  in  the  dream  by  her 
resentment  at  being  asked  by  the  fat  man  to  pidc 
up  something  he  had  dropped.  Gallantry  pre- 
scribes that  gentlemen  should  pick  up  things  for 
ladies ;  in  the  dream  just  the  opposite  takes  place, 
and  a  lady  is  asked  to  pick  up  something^  for  a 
man.  In  this  way  is  represented  the  attitude  of 
her  employer  in  tiie  office,  which  was  just  the  op- 
posite of  gallant 

But  in  the  dream  she  picked  up  a  key  which  she 
saw  lying  on  the  floor,  with  the  thought  that  she 
was  doing  just  the  opposite  of  what  he  wanted. 
Now,  what  does  the  key  meant    Asked  to  associ- 
ate,  the  patient  remarked,  '^A  key  is  something 
you  use  when  you  want  to  get  into  things — ^Yes- 
terday my  mol^er  tore  her  dress  on  a  key  in  the 
bureau.    She  was  very  much  exasperated,  but  I 
told  her  she  must  not  blame  the  key,  because  it 
was  herself,  through  her  carelessness,  that  was  at 
fault    I  meant  that  she  had  made  of  the  key  a 
sort  of  excuse." 

The  key  which  the  patient  picked  up  in  the 
dream  was,  then,  according  to  her  assodations, 
something  that  could  be  made  a  sort  of  excuse^ 
something  upon  which  the  blame  could  be  placed 
when  one^s  self  was  really  at  fault,  and  perhaps 
also  something  which,  like  a  key,  could  be  used  not 
only  when  one  wants  to  get  into  things  but,  in  a 
different  sense,  when  one  wants  to  get  out  of  them. 
Now,  as  we  know,  the  patient  wanted  to  get  out  of 


AN  ANXIETY  HYSTERIA  475 

working  for  her  rich  benefactor.  She  would  have 
been  glad  of  an  excuse  to  withdraw  from  his  em- 
ploy. But  we  have  already  seen  that  her  neurosis 
brought  about  this  withdrawal,  or  in  ot}ier  words 
was  the  excuse  she  wanted.  In  short,  the  thing 
that  she  picked  up  in  the  dream,  and  that  her  asso- 
ciations indicated  was  an  excuse,  was  as  a  matter 
of  fact  her  neurosis.  She  could  use  it  to  get  out  of 
things.  She  could  blame  it  when  what  was  actu- 
ally at  fault  was  her  wish  to  shirk  responsibili- 
ties.* 

The  first  part  of  the  dream  is,  therefore,  his- 
torical, and  its  meaning  or  latent  content  may  be 
summed  up  as  follows.  '^Before  I  became  ill,  my 
employer  treated  me  during  business  hours  with 
so  little  gallantry  and  consideration  that  I  wished 
to  leave  his  employ ;  so  instead  of  trying  to  please 
him,  I  did  just  the  opposite  by  developing  a  neu- 
rosis, which  enabled  me  to  escape  from  the  officei 
and  hide  myself  at  home.'' 

The  rest  of  the  dream  refers  to  the  question  of 
treatment,  for  in  the  dream  after  she  had  hidden 
in  the  house  for  some  time  the  scene  changed  and 
she  started  out  to  join  the  German  Army.  Her 
associations,  which  I  need  not  repeat,  indicated 
that  to  join  the  German  Army  meant  to  be  brave, 
and  in  her  case  thus  represented  an  attempt  to 
overcome  her  fear,  or,  in  other  words,  an  effort 
to  be  cured  of  her  neurosis. 

At  any  rate,  after  setting  out  to  join  the  German 
Army,  or,  as  we  know  it,  after  taking  up  medical 

iThe  "Seeondary  function*'  of  neurotic  illness.    See  Freud's 
'Simmlung  Kleiner  Schriften  Zur  Neurosenlefarey"  Bd.  II. 


476    MORBID  FEARS  AND  COMPULSIONS 

treatment,  she  found  herself ,  as  has  been  said,  in 
the  office  of  a  man  who  was  King  James  II,  but  at 
the  same  time  seemed  to  be  a  priest.  What  doea 
this  meant 

Her  associations  concerning  King  James  II 
finally  led,  without  her  realizing  the  drift  of  them, 
to  her  speaking  of  a  certain  man  of  about  my  age 
whom  she  had  often  mentioned  to  me  because  it 
seemed  to  her  we  were  so  remarkably  alike.  Now, 
this  man's  name  was  James.  But,  since  I  was  so 
much  like  him,  she  could  regard  me  as  a  second 
James,  or  in  other  words,  as  James  the  Second. 
I,  then,  was  the  king  in  her  dream.  In  view  of  this 
there  is  no  real  incongruity  in  the  fact  that  James 
n  in  her  dream  seemed  to  be  a  priest  and  sat  in 
an  office  equipped  with  a  telephone.  She  looked 
upon  me  as  a  priest  because  she  had  to  confess  to 
me. 

The  King's  request,  "Tell  me  about  the  key," 
was  my  request  for  her  to  tell  me  about  her  neu- 
rosis. The  interruptions  which  occurred  in  the 
dream  so  that  it  ended  with  her  story  unfinished 
represent  the  wish  f ulfilhnent.  She  feared  that  if 
she  got  well  she  would  have  to  go  bacd:  to  work  for 
her  former  employer.  Hence  she  wished  inter- 
ruptions or  anything  else  to  occur  which  would  put 
off  the  completion  of  the  analysis.  In  short,  the 
dream  shows  that  a  wish  to  get  out  of  working  was 
not  only  a  factor  in  producing  her  neurosis  but 
would  also  delay  her  recovery.  She  wished  to  re- 
tain some  of  her  symptoms,  for  in  this  way  she 
could  avoid  having  to  go  back  to  work.  She  ac- 
knowledged also  that  she  enjoyed  coming  to  me 


AN  ANXIETY  HYSTERIA  477 

and  that  this  had  furnished  a  motive  for  wishing 
to  defer  her  recovery.  I  must  add  that  one  feat- 
ure possessed  by  the  fat  man  in  the  dream — ^a 
feature  which  for  reasons  of  discretion  I  may  not 
describe-H9uggested  that  the  dream  also  referred 
in  some  way  to  Mr.  Densmore.  We  shall  learn 
later  that  this  was  true,  and  that  her  dislike  of 
work  meant  more  than  at  first  appeared. 

After  this  dream  and  its  analysis  had  been  dis- 
cussed— and  this  time  Miss  S accepted  my  ex- 
planations ahnost  in  toto — things  began  to  pro- 
gress much  more  rapidly.  Though  she  admitted 
that  she  was  not  at  all  enthusiastic  about  return- 
ing to  work,  she  remarked  that  she  did  not  intend 
to  let  this  interfere  with  her  recovery,  for,  as  she 
said,  if  she  could  not  become  resigned  to  working, 
she  could  doubtless  find  some  way  to  avoid  it  even 
if  she  were  welL 

At  this  period  the  patient  rarely  saw  Mr.  Dens- 
more, though  he  formed  a  frequent  theme  in  our 
conversations.  She  still  protested  that  she  dis- 
liked him,  and  as  of  old  she  ridiculed  and  made  fun 
of  him.  If  any  of  her  friends  spoke  of  him  she  al- 
ways took  pains  to  refer  to  him  in  terms  of  de- 
rision and  contempt.  Nevertheless,  it  seemed  to 
me  that  she  was  beginning  to  realize  that,  as  I  had 
explained  to  her,  these  reactions  were  merely  a 
compensation  for  a  real  and  strong  attraction 
which  he  exerted  upon  her,  and  which,  in  my  opin- 
ion, was  definitely  sexual  in  the  ordinary  accep- 
tation of  the  word. 

That  it  was  sexual  in  this  sense  seemed  to  be  the 
chief  reason  why  she  would  not  let  herself  like 


478    MORBID  FEARS  AND  COMPULSIONS 


1 


] 


him.  In  spite  of  all  I  could  do  she  had  not  yet  ap- 
peared to  be  able  to  overcome  the  feelings  that  s^ 
was  essentially  sinful.  Though  now  admittmg 
that  she  was  not  entirely  sexless  and  that  sex  im- 
pulses must  be  normal,  she  asserted  that  she  had 
never  experienced  such  a  base  longing  as  that  for 
physical  sex  relations  with  a  man  and  she  hoped 
she  never  would.    But  these  statements  were  soon 

to  be  contradicted.    About  this  time  Miss  S 's 

mother,  who  all  along  had  felt  that  perhaps  some 

uterine  trouble  was  responsible  for  Miss  S 's 

illness,  expressed  a  desire  to  have  the  girl  exam- 
ined by  a  gynfiBcologist.    Miss  S told  me  about 

this ;  and  though  she  felt  that  such  an  examination  | 
was  unnecessary  she  thought  perhaps  she  might 
better  have  it  merely  to  satisfy  her  mother.  I  gave 
her  the  name  of  a  friend  of  mine  to  whom  she  oonld 
go  for  the  examination  (which,  however,  was  never 
made) ;  and  then  she  asked  if  it  was  all  right  to 
go,  meaning,  might  not  her  hymen  be  ruptured. 
I  of  course  told  her  that  the  doctor  would  take  care 
to  avoid  anything  of  the  kind,  and  she  seemed  sat- 
isfied. A  night  or  two  after  this  she  dreamed  that 
on  my  recommendation  she  had  gone  to  a  man,  ap- 
parently a  doctor,  for  some  sort  of  treatm^it* 
She  found  herself  in  a  room  reading  a  large  book 
which  apparently  the  doctor,  who  seemed  to  be  a 
negro,  had  given  her.  From  the  title  page  she 
saw  that  the  book  was  by  a  Professor  F.  B.  E.  D. 

(the  name  of  a  man  who  will  be  mentioned 

later).  The  treatment  seemed  to  consist  in  the 
reading  of  this  book.  She  saw  in  the  book  some- 
thing about  ^ Aplenty  of  cracked  ice  and  exercise.'' 


• 


AN  ANXIETY  HYSTERIA  479 

WMe  reading  she  kept  glancing  at  the  dock,  the 
idea  being  that  at  a  certain  time  the  doctor's  office 
hour  wonld  be  over  and  then  she  would  go. 

In  view  of  what  has  been  said  the  meaning  of 
some  parts  of  this  dream  are  almost  self-evident, 
though  on  the  whole  the  dream  is  obscure.  The 
person  to  whom  in  the  dream  she  went  for  treat- 
ment apparently  has  some  connection  with  the 
gynsecologist  we  had  spoken  of  and  who  she  was 
afraid  might  rupture  her  hymen.  But  the  man 
seemed  to  be  a  negro.  A  negro,  to  most  American 
girls  is,  in  their  dreams  at  least,  a  symbol  or  per- 
sonification of  masculine  sexual  aggression.  Thus, 
the  patient  dreams  that  through  my  recommenda- 
tion  she  finds  herself  in  a  situation  where  appar- 
ently she  is  exposed  to  a  certain  danger  of  sexual 
aggression  and  rupture  of  her  hymen.  Just  what 
this  situation  is  will  appear  later. 

The  large  book  which  she  read  in  the  dream 
brought  to  her  mind  a  '^Family  Medicine  Book" 
which  her  mother  possessed.  She  now  admitted 
that  she  had  occasionally  referred  to  this  work  in 
the  hope  of  satisfying  her  sexual  curiosity,  and  of 
obtaining  some  information  about  the  relation  of 
the  sex  impulse  to  nervousness.  The  words 
'^ Plenty  of  cracked  ice  and  exercise''  were  a  con- 
densation of  certain  passages  in  this  book  which 
referred  to  the  treatment  of  masturbation.  The 
name  which  she  saw  on  the  title  page  of  the  book 
in  the  dream  was  a  condensation  of  the  name  of 
Professor  Freud,  of  a  psychoanalyst  to  whom  I 
told  her  she  could  go  if  during  my  absence  from 
the  city  she  needed  advice,  and  of  another  man 


480    MORBID  FEAES  AND  COMPULSIONS 

whom  she  regarded  as  an  authority  on  sex.  At 
any  rate^  the  reading  of  the  book,  which  seemed  to 
be  a  sort  of  treatment,  apparently  represented  the 
doing  of  something  that  would  satisfy  her  sexual 
curiosity.  What  this  something  was,  together 
with  additional  associations  with  regard  to  the 
book,  was  brought  out  in  discussing  the  idea  which 
appeared  in  the  dream  that  at  a  certain  time  the 
doctor 's  office  hour  would  be  up  and  she  could  go. 
When  asked  for  associations  on  this  point  she  soon 
reverted  to  the  theme  of  books,  and  at  length  told 
me  of  having  read  an  erotic  novel  entitled  ^'His 
Hour."  The  substance  of  the  part  that  im- 
pressed her  was  as  follows.  A  woman  who  had 
been  married  is  alone  in  the  house  of  a  man  who  is 
in  love  with  her.  He  suggests  intercourse  but  she 
refuses  and  is  prepared  to  defend  herself  with  a 
revolver.  He  knows  she  will  not  kill  him  and  sits 
down  as  if  to  tire  her  out.  At  length,  she  faints. 
When  she  recovers  consciousness  she  finds  her 
clothing  torn  and  disarranged  and  so  concludes 
that  the  man  had  had  intercourse  with  her  while 
she  was  unconscious.  Not  until  the  end  of  the 
book  does  she  realize  that  this  is  not  so  and  that 
during  her  faint  her  lover  ^'did  but  kiss  her  little 
feet" 

In  reading  this  book  the  patient  had  experi- 
enced considerable  sexual  pleasure.  l%ie  idea  of 
the  helplessness  of  the  woman  during  the  fainting 
attack  strongly  appealed  to  her,  and  she  f  antasied 
herself  in  a  similar  situation,  in  which  more  hap- 
pened than  the  kissing  of  feet.  Now  this,  as 
shortly  appeared,  had  been  a  determinant  of  her 


AN  ANXIETY  HYSTERIA  481 

neurosis.  The  time  when  the  man  chased  her  on 
the  street,  on  the  day  preceding  her  first  fainting 
attack,  she  was  still  under  the  influence  of  the 
erotic  excitement  occasioned  by  the  reading  of  this 
book.  Her  inability  to  rtm  was  due  to  her  assault 
fantasies,  which  now,  though  in  a  not  very  accept- 
able way,  seemed  about  to  become  realities.  That 
is  to  say,  her  wish  to  be  caught  (not  by  this  par- 
ticular man,  of  course)  operated  as  a  counter  wish 
to  impede  her.* 

It  is  dear  that  the  fainting  attack  which  oc- 
curred on  the  day  after  her  fright  was  in  imitation 
of  the  woman  in  the  story.    It  occurred  when  she 

knew  Mr.  D was  near  at  hand,  and  it  served  to 

bring  him  to  her  side  and  cause  him  sympathetic 
concern  about  her.  Now  in  the  dream  she  is,  at 
my  suggestion,  in  a  situation  which  apparently  ex- 
posed her  to  sexual  aggression  and  the  loss  of  her 
hymen,  but  which  is  some  sort  of  treatment,  and 
has  to  do  with  the  gratification  of  sexual  curios- 
ity. Her  looking  at  the  dock,  etc.,  suggests  that 
it  is  **His  Hour.'^  Expressed  in  this  way,  the 
dream  is  not  difficult  to  interpret.  The  idea  of 
treatment  is  associated  with  the  idea  of  gratify- 
ing sexual  curiosity.  And  the  best  way  to  gratify 
such  curiosity  is  by  actual  experience.  From 
what  I  had  said  with  regard  to  repressed  wishes 
being  pathogenic,  the  patient  concluded  that  one 
way  to  get  well  was  to  fulfill  these  wishes.  Hence 
she  dreams  that  she  is  having  a  **His  Hour"  ex- 
perience— ^that  as  a  means  of  getting  well  she  f  ul- 

iThis  is  an  excellent  example  of  the  utter  disregard  which 
wishes  of  the  unconscious  have  for  reality. 


482    MORBID  FEAES  AND  COMPULSIONS 

fills  her  sexual  wishes.  The  idea  that  I  was  re- 
sponsible for  her  undergoing  this  sort  of  treat- 
ment corresponds  to  her  wish  to  shift  responsi- 
bility for  what  she  thought  was  wrong.  It  is  evi- 
dent too,  that  she  was  maldng  of  the  psycho-analy- 
sis a  substitute  for  the  wish  for  sexual  experience 

with,  presumably,  Mr.  D ^  and  that  she  had 

thought  of  me,  in  his  place,  as  the  hero  in  an  as- 
sault phantasy. 

It  will  be  remembered  that  the  patient's  chief 
symptom  was  a  fear  that  if  she  went  out  alone  or 
in  the  subway  she  would  get  weak,  faint,  and  die. 
But  we  can  now  interpret  this  by  saying  that  she 
had  been  afraid  that  if  she  continued  well  and  able 
to  work  at  the  office  she  would  get  weak  in  the  sense 

of  giving  way  to  Mr.  D 's  charms,  and  that 

^^her  hour"  would  come,  in  the  sense  of  ultimate 
sexual  relations.  Thus,  as  I  had  suspected  at  the 
beginning  of  the  analysis  the  fear  of  death  was 
actually  a  fear  of  love,  or  rather  of  her  repressed 
longing  for  it. 

The  discussion  provoked  by  the  analysis  of  this 
dream  marked  the  first  pronounced  relaxation  of 
her  resistances.  I  could  point  out  to  her  a  se- 
quence that  showed  most  convincingly  the  exist- 
ence of  a  relationship  between  her  symptoms  and 
repressed  sexuality.  First,  was  the  sudden  flash 
of  sexual  feeling  toward  Mr.  Densmore  in  the 
subway.  Then  came  the  reading  of  the  white 
slave  reports  which  led  her  to  asking  questions 
and  resulted  in  a  condition  in  which  in  spite  of 
herself  the  theme  of  sexual  relations  gained  for 
her  a  fearful  fascination.    Next  was  the  reading 


AN  ANXIETY  HYSTERIA  483 

of  the  erotio  book  wHch|  together  with  what  the 
girl  had  told  her,  provoked  fantasies  of  fainting 
and  assault  and  caused  a  condition  of  consid- 
erable sexual  tension.  Then  the  incident  of  her 
being  chased  by  the  man  in  the  street  Her  in- 
ability to  run  was  determined  by  her  assault  fan- 
tasies which  now,  though  in  a  not  very  acceptable 
way,  seemed  about  to  become  a  reality.  On  the 
following  day  (the  day  of  her  first  attack)  she 
was  expecting  to  make  a  visit  to  the  scene  of  her 
homosexual  experience  and  this  expedition  would 
have  led,  had  it  not  been  for  her  resistances,  to 
her  indulging  in  pleasant  recollections  or  fantasies 
of  a  homosexual  coloring.  But  in  reacting  against 
this  tendency,  her  libido  reverted  more  strongly 
to  Mr.  D — —  and  she  fainted,  the  motive  on 
the  one  hand  being  a  wish  to  escape  from  sexual- 
ity, which  seemed  to  be  on  all  sides  of  her,  and 
on  the  other  for  erotic  experience  corresponding 
to  that  of  the  woman  in  the  book,  but  with  Mr. 
Densmore  in  the  rdle  of  the  hero. 
To  this  interpretation  of  the  situation  Miss 

S gave  partial  confirmation.    She  admitted 

that  probably  I  was  right  in  supposing  that  her  in- 
terest in  Mr.  D was  greater  than  she  had  been 

willing  to  acknowledge.  Soon  after  she  declared 
that  she  had  been  in  love  with  him  all  along  but 
that  she  had  tried  to  avoid  admitting  to  herself 
that  such  was  the  case.  She  stated  too  that  she 
was  sure  that  if  she  were  willing  to  ''let  herself 
go*'  her  love  would  rapidly  increase.  But  though 
she  now  admitted  these  things  she  was  not  con- 
tent  with   them.    Though   admitting   that   Mr. 


486    MORBID  FEABS  AND  COMPULSIONS 

the  dream  we  had  spoken  of  the  biological  mean- 
ing of  the  sex  instinot  and  I  had  taken  occasion  to 
use  some  matter  that  came  up  to  support  the  prop- 
osition that  sexuality  could  not  be  essentially 
*  *  bad. ' '  She  demurred  and  kter  I  said  *  *  Perhaps 
you  do  not  want  to  see  these  things."  Still  later 
I  had  used  the  phrase  *  *  There  are  none  so  blind 
as  those  who  won't  see."  This  was  the  source  of 
the  dream  material  In  the  dream  she  gazes  on  the 
forces  of  nature,  or  of  sex,  in  wonder  and  awe. 
Her  mother  to  whom  she  tries  to  point  out  the  re- 
markable sight,  seems  blind  or  stupid.  In  the 
dream  the  mother  represents  that  phase  of  her 
personality  which  is  identified  with  her  mother; 
the  same  phase  from  which  arose  the  sex  resist- 
ances I  had  been  combating.  At  last  in  the  dream 
she  did  get  her  mother  ^Ho  look  in  the  right  direc- 
tion," or  in  other  words,  she  finally  became  wiQ- 
ing  to  see  the  sexual  life  as  something  fijie  and 
wonderful  instead  of  as  ''dirty"  and  debasing. 

The  stimulus  which  had  resulted  in  this  dream 
was,  I  learned,  as  follows:  It  seems  that  across 
the  court  in  the  apartment  house  where  she  lived 
there  was  a  young  married  couple  whom  she  had 
often  watched  from  her  bed  room.  They  had 
seemed  to  her  to  be  singcQarly  sweet  and  tender 
with  one  another,  and  she  had  regarded  them  as 
strikingly  '*good"  young  people.  On  the  day  of 
her  dream  she  had  learned  that  this  young  woman 
had  given  birth  to  a  baby,  and  in  the  face  of  this 

BntpfanffwiM  der  JungfrtM  Maria  duroh  dot  Ohr.  Jahrbucb  der 
PsychoanalyBe  1914.  Algo,  childreo  are  told  that  babieB  an 
brought  by  a  bird,  the  stork. 


AN  ANXIETY  HYSTERIA  487 

conclusive  evidence  that  they  must  have  had  in- 
tercourse, she  said  to  herself  that  surely  if  such 
sweet  and  innocent  appearing  young  people  prac- 
ticed coitus  there  could  hardly  be  anything  really 
wrong  about  it.^  The  dream  shows  that  there 
had  been  in  existence  two  phases  of  her  person- 
ality; the  one  caused  in  her  by  her  mother's  ap- 
parent attitude  toward  sex  matters  (a  forecon- 
scious  trend)  y  and  another  which  secretly  sided 
with  me  (essentially  of  the  Unconscious). 

The  interpretation  of  this  dream  the  patient 
readily  accepted  and  her  resistances  appeared 
greatly  decreased.  She  had  been  slowly  improv- 
ing up  to  this  time  but  now  her  improvement  be- 
came much  more  rapid,  and  she  felt  as  if  soon  she 
would  be  entirely  well.  But  then  one  morning, 
she  came  late  for  her  appointment  and  reported 
that  she  had  felt  so  badly  that  she  had  been  al- 
most afraid  to  make  the  trip  to  my  office  thinking 
she  would  probably  die  on  the  way.  She  felt  much 
disappointed,  for  the  night  before  she  had  been 
thinking  that  on  this  day  for  the  first  time,  she 
would  try  to  make  the  trip  to  my  office  alone. 
During  the  night  she  had  dreamed  tiiat  she  was  in 
a  wedding  dress  and  about  to  be  married.  Then 
suddenly  she  changed  her  mind  and  felt  that  she 
did  not  wish  to  marry  and  that  she  would  die  if 
she  did.  She  told  this  to  her  mother,  who  stood 
by  in  the  dream,  but  her  mother  urged  her  to  go 
ahead.  The  girl  would  not  do  so,  however,  and 
was  about  to  run  away  when  she  awoke. 

1  Another  element  in  the  life  of  these  young  people  also  affected 
her^  as  we  shaU  hear  later. 


488    MOBBED  FEABS  AND  COMPULSIONS 

The  general  meaning  of  the  dream  is  plain 
enough.  She  had  regarded  herself  as  just  on  the 
point  of  getting  welL  In  the  dream  she  is  just 
on  the  point  of  gettrog  married.  Apparently  she 
had  identified  the  two  things.  Her  illness  had  ex- 
pressed her  resistances  against  marriage,  and  to 
get  well  meant  to  overcome  these  resistances,  and, 
in  this  sense,  to  be  ready  to  marry.  The  dream 
thus  shows  that  she  has  changed  her  mind;  that 
she  still  had  some  resistances  toward  the  idea  of 
marriage,  or,  what  was  equivalent,  toward  Mr. 
Densmore. 

After  this  her  resistances  against  sex  seemed 
to  return  somewhat  for  she  again  began  to  re- 
peat her  earlier  assertions  that  such  things  were 
dirty.  She  decided  that  she  did  not  want  to  see 
Mr.  Densmore  and  let  herself  become  more  fond 
of  him,  because  of  her  repugnance  to  the  dirty 
things  that  marriage  would  involve. 

She  said  also  that  there  was  another  and  equally 
important  reason  why  she  did  not  want  to  mariy 
him  and  of  this  she  began  to  talk  a  good  deaL  It 
seems  that  Mr.  Densmore  had  a  woman  relative 
who  had  divorced  her  husband.  Miss  Sunderland 
asserted  that  she  was  unwilling  to  marry  into  a 
family  where  such  a  thing  had  taken  place.  She 
felt,  she  said,  that  the  whole  family  was  somehow 
tainted,  and  that  the  tendency  to  infidelity  and 
cruelty  ^  which  she  supposed  had  been  displayed 

1  She  had  no  definite  information  ae  to  what  wwe  the  gronndt 
upon  which  the  divorce  was  obtained.  The  divorce  occurred  in 
another  state,  and  that  infidelity  and  cruelty  were  the  grounds 
for  it,  Miss  Sunderland  merely  assumed. 


AN  ANXIETY  HYSTERIA  489 

by  the  divorced  husband  would  sooner  or  later 
crop  out  in  Mr.  Bensmore.  This  fear  that  he 
might  be  cruel  had  arisen  on  a  certain  occasion 
when  she  heard  him  order  a  waiter  around  rather 
roughly. 

I  could  not  convince  myself  that  a  girl  as  intel- 
ligent as  Miss  S could  be  deterred  from  marry- 
ing a  man  she  loved  merely  because  there  was  a 
divorce  in  his  f amily,  nor  could  I  believe  that  she 
was  really  sincere  in  supposing  that  the  assumed 
brutal  and  immoral  tendencies  of  the  divorced 
man  could  have  been  transmitted  to  Mr.  Densmore 
and  the  rest  of  his  family — Mr.  Densmore  was  not 
a  blood  relative  of  the  man,  but  only  a  connec- 
tion by  marriage.  Nor  did  I  think  that  a  little 
roughness  in  her  husband — ^such,  for  instance  as 

Mr.  D displayed  toward  the  waiter — would  be 

altogether  distasteful  to  her.  She  seemed  to  have 
a  rather  strong  masochistic  tendency  and  a  certain 
degree  of  masterfulness  in  a  man  would,  in  my 
opinion,  have  appealed  to  her.  The  fact  was  un- 
questionable,   however,    that    these    resistances, 

against  Mr.  D ,  absurd  as  they  seemed,  were 

not  to  be  removed  by  pointing  out  their  very  ap- 
parent absurdity.  That  the  resistances  were  real, 
there  seemed  to  be  no  doubt,  though  I  could  hardly 
believe  that  they  arose  from  the  source  to  which  the 
patient  attributed  them.  At  no  time  would  she  ad- 
mit their  unreasonableness  and  absurdity. 

There  came  to  my  mind  finally  an  observation  I 
had  made  in  certain  other  cases  which  seemed  to 
afford  a  possible  explanation  of  this  resistance, 


490     MORBID  FEAES  AND  COMPULSIONS 

namely,  that  when  a  person  is  vacillating  between 
two  divergent  courses  and  can  not  bring  himself 
to  give  np  the  attractive  features  of  either  one  in 
favor  of  the  advantages  of  the  other,  he  has  a 
tendency  to  see,  or  to  imagine  that  he  sees,  in  one 
course  disadvantages  that  really  belong  to  the 
other,  where,  however,  he  is  loath  to  see  them. 
Thus,  for  example,  if  a  man  were  trying  to  find 
excuses  for  staying  in  the  city  in  the  summer,  he 
might  say  to  himself,  ''Oh  those  country  houses 
are  so  terribly  hot  and  ill  ventilated,  etc.,'*  while 
as  a  matter  of  fact,  the  heat  and  the  lack  of  air 
circulation  is  one  of  the  most  disagreeable  feat- 
ures of  remaining  in  the  city,  and  one  of  the 
strongest  reasons  for  going  to  the  country. 

On  this  basis  I  began  to  suspect  that  the  patient 
wished  to  follow  some  course  contrary  to  that  of 
marrying  Mr.  Densmore  but  against  this  course 
the  stigma  of  divorce  and  of  the  possibility  of 
cruelty  arose,  not  as  an  imaginary  but  as  a  real 
objection,  and  that  it  was  the  attractive  features 
of  this  course  which  were  the  real  sources  of  that 
resistance  against  marriage  with  Mr.  Densmore 
which  we  have  been  discussing. 

This  conclusion  was  finally  confirmed  by  the 
analysis  of  the  following  dream.  ''I  was  some- 
where in  a  fine  house.  A  woman  was  showing  me 
beautiful  dresses  which  I  was  to  try  on.  It 
seemed  I  was  about  to  marry  a  rich  man,  who 
was  giving  me  all  these  things  and  who  could 
give  me  anything  I  wanted.  Then,  I  realized  that 
the  man  I  was  marrying  was  a  foreigner,  perhaps 
a  Chinaman,  and  I  ran  away,  feeling  that  I  could 


AN  ANXIETY  HYSTERIA  491 

much  more  easily  do  without  the  things  he  could 
give  me  than  get  them  at  such  a  price.'' 

The  idea  of  a  Chinaman  brought  to  the  patient's 
mind  a  newspaper  story  she  had  recently  read 
about  a  wealthy  Chinese  who  had  a  beautiful  white 
girl  as  his  mistress.  Then  came  something  she 
had  never  mentioned  before. 

She  confessed  that  before  she  became  ill  she  had 
met  at  a  dinner  a  very  wealthy  foreigner  who  im- 
mediately becamQ  impressed  with  her  and  paid  her 
most  conspicuous  attentions.  She  was  quite  dis- 
posed to  think  he  would  ask  her  to  marry  him  if 
she  gave  him  the  least  encouragment.  She  did 
not  love  the  man  but  the  idea  of  a  rich  marriage 
strongly  appealed  to  her.^  On  the  other  hand, 
Mr.  D- — ,  as  she  now  admitted,  had  less  money 
than  almost  any  of  the  other  young  men  she  knew. 
Though  his  prospects  were  good,  she  knew  her 
life,  if  she  married  him,  would  at  first  be  anything 
but  luxurious,  and  she  would  have  to  consider 
herself  lucky  if  she  had  a  servant  to  help  her 
with  the  work.  Such  a  prospect  was  not  alto- 
gether to  her  fancy. 

After  this  disclosure  there  came  a  still  more 
interesting  item.  The  foreigner  had  already  been 
married  and  his  wife  had  divorced  him,  on  the 
ground  of  infidelity.  In  the  newspaper  accounts  of 
the  divorce  which  Miss  S- —  had  read  there  were 
some  more  or  less  definite  charges  of  cruelty. 
These  were  the  facts  that  had  caused  the  patient 

iHer  desire  for  a  rich  marriage  was  partljr  the  result  of  her 
experience  with  her  rich  employer.  The  foreigner  was  a  suhstl* 
tuie  for  him. 


492    MORBID  FEAES  AND  COMPULSIONS 

to  exaggerate  the  significance  of  a  divorce  having 

oocnrred  in  Mr.  D 's  family  and  to  persuade 

herself  that  he  might  be  craeL  Her  wish  for 
wealth  was  the  motive.  If  she  could  make  herself 
believe  that  the  objections  to  the  foreigner  also  ap- 
plied to  Mr.  D y  then  there  would  be  that  mneh 

less  reason  for  not  taking  the  one  who  had  the  most 
money.  Dirt  is  often  a  symbol  for  money  and  this 
may  have  had  something  to  do  with  her  resistance 

to  marrying  Mr.  D ,  which  she  rationalized  by 

saying  that  sexuality  is  dirty.  It  was  really  the  at- 
traction of  dirt — ^filthy  lucre — ^from  another  quar- 
ter which  was  the  source  of  this  resistance.^ 

In  the  light  of  all  this  the  meaning  of  her  dream 
is  evident.  To  marry  the  rich  foreigner  would 
be  to  make  of  herself  a  sort  of  prostitute — Whence 
her  identification  with  the  white  slave  mistress 
of  the  rich  Chinaman.  The  dream  shows  that 
Miss  S had  decided  to  give  up  the  idea  of  ob- 
taining wealth  in  this  way. 

After  the  dream,  Miss  S went  on  to  explain 

that  Mr.  D had  begun  to  pay  her  attentions, 

and  she  to  like  him,  before  she  met  the  foreigner.' 
But  when  she  did  meet  him,  and  began  to  believe 
that  all  his  wealth  would  be  at  her  disposal  if  she 
wanted  it,  she  commenced  to  repress  her  interest 

1  The  dream  about  the  bird  which  seemed  to  be  connected  with 
thoughts  about  the  young  couple  next  door  and  which  marked  a 
relaxation  of  her  resistances  must  be  connected  with  an  idea 
gained  by  watching  the  young  people  that  one  could  be  happy 
without  wealth. 

2  The  foreigner  was  40  years  of  age— one  of  her  alleged  objec- 
tions to  Mr.  Densmore  was  that  he  was  too  young — ^'a  mere  boy^" 
though  he  was  eight  years  older  than  she. 


AN  ANXIETY  HYSTERIA  493 

in  Densmore^  and  to  try  to  like  the  foreigner, 
without  however  meeting  with  entire  success  in 
either  direction.  Then  she  made  up  her  mind  that 
she  would  not  attempt  to  decide  the  matter  either 
way,  but  that  instead,  she  would  go  to  parties  and 
dances  as  much  as  she  could,  in  the  hope  that  she 
might  meet  some  new  man  who  on  the  one  hand 
would  be  as  rich  as  the  foreigner  and  on  the  other 
as  lovable  as  Densmore.  But  at  this  point  came 
the  outbreak  of  the  neurosis.  It  was  a  sort  of  re- 
sultant of  all  these  conflicting  forces.  On  the  one 
hand  it  interfered  with  the  social  activities  she 
had  planned  and  thus  served  to  keep  her  faithful 
to  Mr.  Densmore.  On  the  other,  it  kept  her  from 
seeing  so  much  of  him  that  she  would  become 
deeply  enough  in  love  to  renounce  the  money,  and 
in  like  manner  it  kept  her  from  seeing  much  of 
the  foreigner. 

Her  morbid  fear  that  if  she  went  out  alone  she 
would  **fall''  (in  a  faint,  etc.)  which,  as  we  know, 
came  on  shortly  after  her  reading  about  white 
slavery  in  the  papers,  is  really  connected  in  a 
more  intimate  way  with  the  idea  of  white  slavery. 
If  she  married  the  foreigner  merely  for  his  money 
she  would  in  a  certain  sense  fall.  Her  act  would 
be  a  form  of  prostitution  and  she  a  white  slave. 
On  the  other  hand,  if  she  married  Mr.  Densmore 
she  might  regard  herself  as  being  a  white  slave 
in  quite  another  sense — ^that  is  she  might  have  to 
work  harder  than  was  to  her  liking.  We  now 
see  that  these  matters  were  dealt  with  in  the 
dream  of  King  James  II.  Her  running  away 
from  the  fat  man  who  ordered  her  around  referred 


494    MORBID  FEARS  AND  COMPULSIONS 

on  the  one  hand  to  her  wish  not  to  have  to  work 
(as  the  wife  of  Mr.  Densmore)  and  on  the  other 
to  her  impulse  to  escape  from  the  wealthy  man 
(the  foreigner  who  was  concealed  behind  her  em- 
ployer) because  she  did  not  like  him  as  a  husband* 

After  the  analysis  of  this  dream  the  patient 
improved  with  great  rapidity.  She  seemed  now  to 
understand  what  her  illness  meant,  and  felt  confi- 
dent that  she  would  soon  be  welL  Of  her  own  su^ 
cord  she  came  to  my  office  alone,  and  she  experi- 
enced no  fear  or  other  unpleasant  symptoms  on 
the  way.  At  last,  she  told  me  of  a  plan  she  had 
devised  to  get  Mr.  Densmore  to  renew  his  atten- 
tions— she  had  not  been  seeing  him  for  some 
time,  for  he  apparently  had  given  her  up  in  de- 
spair— and  at  the  same  time  announced  that  she 
did  not  feel  it  necessary  that  she  should  come  to 
me  any  more.  I  saw  her  a  month  later  and  she 
reported  that  Mr.  Densmore  had  promptly  re- 
sponded to  her  scheme  and  that  she  was  having 
a  most  delightful  time  with  him.  She  felt  that 
she  loved  him  and  that  everything  would  be  welL 
I  saw  her  a  few  other  times  at  long  intervals  and 
each  time  she  reported  herself  to  be  in  the  best 
health  and  spirits.  She  married  Mr.  Densmore  a 
year  or  more  after  the  completion  of  the  analysis, 
and  when  I  last  heard  from  her,  she  was  well  and 
happy. 

For  the  sake  of  completeness,  I  might  add  that 
my  experience  with  later  and  more  deeply  an- 
alyzed cases  indicates  that  morbid  fears  of  attacks 
of  unconsciousness — ^fainting,  epilepsy,  etc. — ^have 
reference  to  a  period  of  bed-wetting  in  the  child- 


AN  ANXIETY  HYSTERIA  495 

hood  of  the  patient  and  possess  as  one  of  their  old- 
est and  deepest  roots  a  certain  urethral-erotio 
tendency  and  the  corresponding  unconscious  fan- 
tasies. Though  this  was  not  definitely  worked  out 
in  the  case  of  Miss  Sunderland,  considerable  of  the 
material  brought  out  in  her  analysis  (not  all  of 
which  I  have  reported)  strongly  suggests  that 
such  was  one  of  the  determinants  of  her  symp- 
toms, e.  g.  her  dream  of  urinating  on  the  ground, 
the  history  of  bed-wetting,  her  notion  that  the  sex 
relations  are  dirty,  etc. 

The  only  state  of  unconsciousness  and  irrespon- 
sibility which  children  know  about  is  that  of  sleep, 
and  it  must  be  a  rather  impressive  experience  for 
them  to  find  that  a  condition  is  possible  in  which 
they  do,  without  knowing  about  it  and  without 
being  held  very  much  to  blame,  a  thing  which  if 
done  voluntarily  and  in  the  conscious  state  would 
win  them  severe  punishment.  It  is  not  surprising 
then  that  in  later  years  when  there  break  out  con- 
flicts with  wishes  which,  if  acted  upon  voluntarily 
would  expose  the  individual  to  social  censure  or 
punishment  or  to  the  misery  of  self  reproach, 
there  should  arise  a  wish  (or  fear)  of  sleep-like 
states  in  which  the  repressed  desires  could  be  con- 
ceived of  as  being  involuntarilj/  fulfilled. 

Furthermore,  the  teasing  and  ridicule  over  not 
having  control  of  their  sphincters,  and  the  occa- 
sionally none  too  tolerant  attitude  of  the  parents, 
have,  in  certain  cases,  the  effect  of  laying  the 
foundation  f 6r  a  feeling  of  inferiority  and  sensi- 
tiveness which  may  persist  throughout  the  indi- 
vidual's life  and  forever  act  as  an  inhibition  upon 
the  normal  expression  of  the  sexual  activities. 


CHAPTER  X 

THB  THBOBY  AND  ME0HANI8M  OF  THB 
PSYOHOANAIiYTIO   CI7BB 

IF  the  reader  has  closely  followed  the  preoed- 
ing  chapters,  he  may  complain,  on  having 
finished  them,  that  certain  of  the  items  set 
forth  in  the  discussion  of  theory  were  not  brought 
out  concretely  by  the  two  case  reports  which  have 
been  given.  These  cases  did  not,  for  instance, 
demonstrate  the  infantile  factors  to  be  as  impor- 
tant as  perhaps  he  had  been  led  to  expect,  nor  did 
they  show  beyond  all  peradventure  the  neurosis  to 
be  the  negative  of  the  perversion.  The  matter  of 
transf erejace,  though  it  came  up,  apparently  did 
not  play  the  dominant  role  which  the  reader  might 
have  been  prepared  to  find  it  occupying. 

Such  complaints  would  not  be  unjust,  for,  as 
I  am  well  aware,  the  reports  I  have  given  do 
possess  these  defects,  as  well  as  other  similar 
ones.  On  the  other  hand  the  fact  that  I  have 
chosen  them  for  reporting  is  not  without  justifica- 
tion. As  I  originally  planned  this  book,  I  had  in- 
tended that  the  last  chapter  should  consist  of  a 
report  of  a  case  so  completely  analyzed  as  fully 
to  illustrate  all  the  points  raised  in  discussing  the 
theoretical  aspects  of  the  neuroses.  I  thought  by 
this  means  to  make  up  for  the  defects  of  the  two 
earlier  cases,  which  I  had  felt  would  serve  an  XBr 

496 


CATHARTIC  METHOD  497 

troductory  function  better  than  others  more  elab- 
orately analyzed.  But  I  know  now,  from  having 
failed  at  it^  that  I  had  set  myself  an  impossible 
task.  That  is  to  say,  my  later  and  better  analyzed 
cases,  which  gave  full  illustration  of  the  theories 
here  set  forth,  represented  such  an  enormous  mass 
of  intricate  and  almost  endless  detail  that,  without 
destroying  their  scientific  value,  I  could  not  com- 
press any  one  of  them  into  a  narrative  short 
enough  to  be  included  within  this  volume.  I 
therefore  decided  to  complete  this  book  with  a 
chapter  on  the  theory  of  the  psychoanalytic  treat- 
ment and  to  endeavor  to  make  up  for  the  fact  that 
my  two  cases  here  reported  fail  to  fulfill  all  that 
might  be  desired  of  them  as  illustrative  material 
by  writing  a  supplementary  volume  which  would 
be  devoted  to  a  single  detailed  case  report*  For, 
as  a  matter  of  fact,  the  full  report  of  any  case 
which  is  completely  analyzed  deserves  a  volume 
by  itself  and  cannot  be  accurately  presented  by 
anything  short  of  it. 

In  the  twenty-five  years  that  have  elapsed  since 
Breuer  and  Freud  published  their  first  paper  on 
hysteria,  the  theory  and  technique  of  psychoanaly- 
tic treatment  have  passed  through  a  number  of 
evolutionary  changes.  The  method  had  its  be- 
ginning in  1880  when,  in  studying  the  case  of  an 
hysterical  girl,  Breaer  found  that  the  symptoms 
of  her  malady  vanished  when  she  could  be  made 
to  remember  in  full  detail  the  situations  and  as- 
sociative connections  under  which  they  first  ap- 
peared. When  ten  years  later  Breuer  and  Freud 
together  took  up  the  investigation,  which  in  the 


498    MOBBID  FEAES  AND  COMPULSIONS 

meantime  had  been  neglected,  there  was  developed 
the  so-called  cathartic  method  of  treatment. 
They  came  to  the  condnsion  that  certain  patho- 
logical experiences,  to  which  the  patients  had  in- 
adequately reacted,  played  the  role  of  psychic  trau- 
mata, causing  the  neurotic  symptoms  analogously 
to  the  physical  traumata  which  Charcot  had  re> 
garded  as  causative  for  hysterical  paralysis.  The 
technique  of  the  treatment  then  was  to  restore  to 
the  patient,  by  means  of  hypnosis,  a  perfect  mem- 
ory of  these  pathogenic  experiences  and  of  the  set- 
ting in  which  the  symptoms  first  appeared,  afford- 
ing in  this  way  free  discharge  to  the  previously 
strangulated  affects.     (Abreaction.) 

After  a  time  Freud  abandoned  hypnosis  as  a 
means  for  filling  out  the  gaps  in  the  patient's 
memory,  and  adopted  instead  the  method  of  free 
association.  The  patient  was  asked  to  concen- 
trate his  mind  on  some  given  symptom  or  on  some 
point  where  his  memory  of  connections  or  of 
events  was  obviously  incomplete,  and  then  to  re- 
late all  the  thoughts  that  came  to  him.  The  phy- 
sician sought  to  divine  from  the  associations  thus 
produced  the  missing  material  that  the  patient 
was  unable  to  remember.  The  resistances  which 
had  kept  this  material  unconscious  and  prevented 
recall  were  then  to  be  circumvented  by  the  phy- 
sician's imparting  to  the  patient  the  reconstruc- 
tion derived  from  the  study  of  the  associations. 
Abreaction,  upon  which  so  much  emphasis  had 
been  laid  earlier,  now  retired  from  the  foreground 
and  its  place  seemed  to  be  taken  by  the  expendi- 
ture of  energy  required  of  the  patient  in  resisting 


PBESENT  TECHNIQUE  499 

the  censorship  over  his  incoming  associations. 
The  doctrine  of  complexes  came  into  vogue,  and 
the  physician  bent  his  energies  to  figuring  out 
what  complexes  were  behind  each  given  symptom 
and  describing  them  to  the  patient  as  soon  as  the 
discovery  was  made. 

Then  came  a  further  change  which  brought 
the  technique  into  the  form  which  is  in  use  to-day. 
The  physician  no  longer  concentrated  upon  the 
symptoms  themselves  or  strove  to  discover  and  as 
soon  as  possible  to  impart  to  the  patient  a  correct 
interpretation  of  them.  Instead  of  making  an 
attack  upon  some  definite  manifestation  of  the 
disorder,  the  physician  now  assumed  a  more  pass- 
ive and  expectant  attitude,  and,  directing  the  pa- 
tient to  talk  about  whatever  came  to  his  mind, 
waited  for  him  to  unfold  his  personality  to  view 
without  being  concerned  as  to  what  manner  and 
what  order  the  different  constituents  took  in  mak- 
ing their  appearance.  Instead  of  using  the  inter- 
pretation of  free  associations,  dreams,  etc.,  as  a 
means  of  getting  hold  of  the  submerged  psychic 
material  and  dragging  it  to  the  surface  while  the 
resistances  were  still  in  force,  these  procedures 
were  principally  employed  in  attacking  the  resist- 
ances themselves,  which  were  interpreted  and  ex- 
plained to  the  patient  so  that  through  understand- 
ing they  might  be  overcome.  For  it  was  found 
that  when,  through  successive  interpretations,  the 
resistances  were  worn  away,  the  patient  was  then 
able,  spontaneously  and  without  effort,  to  recall 
and  relate  the  forgotten  situations,  phantasies, 
wishes,  connections  and  so  on  which  were  re- 


500    MORBID  FEARS  AND  COMPULSIONS 

quired  for  a  complete  picture  of  the  ensemble  of 
factors,  conscious  and  unconscious,  which  had  to 
do  with  the  development  and  continuance  of  the 
disease. 

As  soon  as  the  resistances  became  the  first  con- 
sideration in  the  technique,  the  transference, 
which  is  the  source  of  the  most  stubborn  and  baf- 
fling of  all  resistance,  became  one  of  the  most  im- 
portant problems. 

The  essential  goals  of  these  various  techniques 
have  remained  the  same  from  the  start;  on  the 
one  hand  the  overcoming  of  the  repression  resist- 
ances, on  the  other  the  filling  out  of  the  gaps  of 
memory,  the  bringing  into  consciousness  of  the 
pathogenic  material  from  the  unconscious.   « 

In  thinking  this  over  we  come  upon  one  of  the 
most  interesting  and  yet  most  baffling  questions 
that  analysis  has  yet  presented.  Why  is  it  that 
when  the  resistances  are  overcome  and  the  mem- 
ory gaps  filled  out,  the  patient  is  then  wellf  How 
does  this  cure  himf 

That  a  person  can  be  cured  in  this  way  is  in- 
deed a  remarkable  fact.  It  is  by  no  means  self- 
evident  why  the  overcoming  of  repressions  or  the 
filling  out  of  gaps  of  memory  should  render  a 
sick  person  well.  In  fact  ** common  sense*'  would 
perhaps  tell  us  that  at  least  the  latter  feature  (the 
filling  out  of  gaps  of  memory,  the  bringing  up  of 
all  sorts  of  unpleasant  recollections  out  of  the 
past)  should  tend  rather  to  make  him  worse. 
Indeed  the  psychoanalytic  cure  seems  to  be  with- 
out parallel  in  human  experience.  How  are  we  to 
explain  itt 


EXPLANATION  OF  CUBE  501 

As  a  matter  of  f  act,  a  completely  adequate  ex- 
planation has  yet  to  be  formulated.  Most  psy- 
choanalytic writers  have  made  no  very  serious 
attempts  to  account  for  the  results  of  analysis. 
Freud  himself  has  said  comparatively  little  about 
the  question.  The  explanations  of  the  cure  which 
have  been  given  amount  to  little  more  than  say- 
ing: ''It  is  the  understanding  of  himself  which 
the  patient  gains  through  the  analysis  which  cures 
him'*  or  *'when  the  previously  unconscious  patho- 
genic trends  are  rendered  conscious,  the  patient 
is  then  in  a  position  so  to  dispose  of  them  that 
they  no  longer  work  pathogenically.*'  These  ex- 
planations are  perhaps  correct  enough  as  far  as 
they  go,  but  they  by  no  means  tell  the  whole  story. 
Why^  for  instance,  should  the  understanding  of 
himself,  which  the  patient  gains  in  the  analysis, 
have  the  effect  of  curing  himf 

To  tell  the  truth,  it  seems  to  me  that -in  the  pres- 
ent state  of  our  knowledge  the  analytic  cure  can- 
not be  fully  explained.  The  only  explanations 
that  can  at  present  be  advanced  involve  items 
which  themselves  require  explaining,  or  give  rise 
to  questions  which  as  yet  no  one  is  fidly  prepared 
to  answer.  On  the  other  hand  the  cure  which 
results  from  analysis  is  no  absolute  mystery. 
We  can  go  a  certain  and  perhaps  a  considerable 
distance  toward  explaining  it — ^further,  possibly, 
than  any  one  has  made  any  effort  to  go,  for,  as  it 
seems  to  me,  the  question  of  why  analysis  does 
cure  is  one  which,  on  the  whole,  has  been  rather 
neglected  by  psychoanalytic  writers. 

The  explanation  I  should  like  to  offer  is  some- 


502    MORBID  FEAES  AND  COMPULSIONS 

what  more  elaborate  than  those  nsnally  given 
thongh  I  cannot  claim  that  it  adds  anything  really 
new  to  thenL  In  attempting  to  set  it  forth  I  wish, 
first  of  all,  to  emphasize,  and  to  ask  the  reader  to 
bear  in  mind  thronghont,  that,  in  point  of  view  of 
effect,  the  overcoming  of  resistance  and  the  filling 
oat  of  gaps  of  memory  are  identical,  or  at  least 
inseparable.  The  filling  out  of  memory  gaps  re- 
qnires  the  overcoming  of  resistances;  the  over- 
coming of  resistance  requires  gaps  of  memory  to 
be  fiUed  out.  The  two  processes  go  hand  in  hand; 
each  is  a  part  of  the  other.  This  fact  of  the  con- 
fluence or  basic  continuity  between  what,  at  first 
glance,  seem  to  be  two  essentially  different  proc- 
esses gives,  it  seems  to  me,  the  indication  of  the 
direction  which  any  adequate  attempts  to  explain 
the  psychoanalytic  cure  must  at  first  take. 

Let  us  look  at  the  problem  first  from  its  dyna- 
mic side,  namely,  Why  is  it  that  a  cure  is  brought 
about  through  the  overcoming  of  resistances  f  A 
partial  answer  to  this  question  may  be  given  by 
way  of  an  analogy.  It  need  hardly  be  said  that 
the  state  of  a  man  having  strong  and  continually 
unfulfilled  wishes  and  no  prospect  of  fulfilling 
them  may,  without  the  introduction  of  any  addi- 
tional factor,  be  one  of  considerable  unhappinesa. 
The  constant  tension  of  desires  unsatisfied  is  in 
itself  a  source  of  pain.  For  instance,  a  man  serv- 
ing a  term  of  life  imprisonment  is  ordinarily  a 
very  unhappy  person,  yet,  save  for  the  actual 
physical  discomforts  of  prison  life  (which  cer- 
tainly in  most  instances  are  not  nearly  so  great  as 
those  which  a  soldier  in  the  trenches  bears  very 


NEUROTIC  UNHAPPINESS  503 

cheerfully)  he  has  not  much  to  worry  him  except 
his  unfulfilled  wishes.  His  unhappiness  results 
for  the  most  part  we  would  say  from  his  ^^lack  of 
freedom.'*  Almost  everything  he  would  like  to 
do  he  cannot  do.  Nearly  every  wish  he  has  must 
forever  remain  unsatisfied.  And  as  is  well  known 
there  results  in  a  certain  number  of  cases  not  only 
a  state  of  great  unrest  and  unhappiness,  but  of 
actual  mental  illness,  the  prison  psychoses  and 
other  disturbances.  In  fact  some  of  these  condi- 
tions, much  like  the  neurosis,  represent  an  effort 
to  ameliorate  the  unbearable  state  of  tension  from 
the  non-fulfillment  of  all  wishes  by  supplying  a 
phantastic  fulfillment — ^the  delusion  of  a  pardon 
and  other  psychotic  wish-fulfillment  formations. 
Now  the  unhappiness,  the  suffering,  the  sense  of 
being  ill,  which  the  neurotic  suffers  is  in  many  re- 
spects analogous  in  origin  to  the  unhappiness  of 
a  man  in  prison.  A  part  of  it  corresponds  to  the 
pain  of  desires  ungratified ;  the  constant  tensions 
of  longings  unassuaged.  A  part  of  it,  too,  corre- 
sponds to  a  sense  of  guilt,  which  of  course  may  be 
a  factor  in  the  unhappiness  of  the  prisoner  in  con- 
finement. And  though  I  have  had  no  opportunity 
to  study  prison  inmates,  I  am  very  much  disposed 
to  think  that  a  sense  of  guilt  is  a  much  larger  com- 
ponent in  the  misery  which  the  scrupulously 
moral  neurotic  suffers,  than  in  the  unhappiness  of 
the  incarcerated  criminal.  For  the  one  has  a  con- 
science which  in  many  cases  is  over  acute  while 
the  conscience  of  the  other  is  as  a  rule  subnormal. 
The  one  does  not  have  to  violate  any  important 
moral  law  in  order  to   feel  guilty,  while  the 


504    MORBID  FEAES  AND  COMPULSIONS 

other  may  violate  almost  any  law  without  re- 
proaching himself  at  all,  providing  he  escapes 
punishment. 

But  while  in  the  case  of  the  prisoner  the  re- 
straints responsible  for  the  pain  of  many  wishes 
chronically  unfulfilled  are  physical  and  external 
oneSy  those  restraints  which  have  the  similar  ef- 
fect in  the  neurotic  are  endogenous  and  psychic 
ones.  The  prisoner  may  straggle  against  bolts, 
bars  and  chains,  but  the  struggle  of  the  neurotic 
is  against  himself.  His  prison  is  his  own  mind, 
he  was  condemned  by  his  own  laws  and  sentenced 
on  his  own  judgment;  he  himself  is  his  own 
keeper.  He  has  therefore  not  only  the  miseries 
that  are  much  the  same  in  origin  as  those  suffered 
by  a  person  in  prison  (the  pain  of  unsatisfied 
wishes  and  the  torment  of  a  sense  of  guilt)  ^  but 
others  more  difficult  to  factor  which  arise  from 
the  circumstance  that  the  restraining  forces  are 
psychic  and  a  part  of  himself.  Morbid  fear,  in 
part  at  least,  belongs  to  that  category. 

Now  the  codes  according  to  which  the  neurotic 
was  sentenced  and  the  psychic  bars  by  which  he  is 
confined  are  none  other  than  the  resistances  which 
the  analysis  overcomes.  The  analysis  renders 
him  free  to  fulfill  his  wishes — ^not  that,  except  to  a 
limited  extent,  he  then  fulfills  them  in  their  orig- 
inal form,  for  the  analysis  does  not  confer  license; 
the  patient  still  has  to  adapt  himself  to  reality,  to 

iThe  flense  of  guilt  which  may  he  a  large  contrihutor  to  the 
neurotic's  misery  is  by  no  means  invariably  perceiTed  by  him  as 
guilt.  More  often  it  is  so  subject  to  displacement  or  distortion  as 
to  be  regarded  hy  him  as  some  other  sort  of  unpleasant  feeling. 


OEIGIN  OF  EESISTANCES  505 

the  demands  of  civilized  existence.  Bather  the 
analysis  makes  practical  the  establishing  of  a 
TninJTnnTn  of  non-fulfilled  wishes  and  a  maxi- 
mum of  wish  fulfillment  by  making  it  possible  for 
the  patient  to  satisfy  by  way  of  sublimation  many 
wishes  of  such  a  nature  that  previously  they  could 
only  be  expressed  in  symptoms.  In  this  sense  the 
overcoming  of  resistances  releases  him ;  he  is  now 
free  to  gratify  in  suitable  manner  a  great  number 
of  wishes  that  previously  were  relatively  unful- 
filled. To  some  extent  the  analytic  cure  is  then 
analogous  to  the  relief  which  a  prisoner  expe- 
riences if  he  is  declared  innocent  and  let  out  of 
prison.  There  is  done  away  with  the  constant 
urge  of  unsatisfied  wish  tensions^  the  torments  of 
guilty  conscience  (if  that  had  been  an  element  in 
the  case)  and  in  addition  that  less  easily  defined 
factor  which  depends  on  the  fact  that  the  individ- 
ual's  struggle  for  freedom  was  against  himself. 
But  such  an  explanation  as  this  tells  only  a  part 
of  the  story  and  gives  a  very  inadequate  picture 
of  what  really  takes  place  in  the  analytic  cure. 
We  must  go  into  the  matter  further. 

Let  us  now  ask  what  are  the  resistances  which 
the  analysis  overcomes.  How  are  they  consti- 
tuted?   What  is  their  origin! 

After  a  fashion  we  have  answered  these  ques- 
tions in  earlier  chapters.  The  resistances  belong 
in  the  main  to  the  higher  psychic  systems,  espe- 
cially to  the  foreconscious.  In  general  they  are 
trends  which  have  an  inhibiting,  a  repressing  ef- 
fect upon  the  primary  tendencies  of  the  individual, 
the  instinctive  and  infantile,  or,  in  other  words. 


I 


506    MORBID  FEAES  AND  COMPULSIONS 

upon  the  nnconscioos.  Furthermore  they  cor- 
respond to  that  in  the  personality  which  is  ac- 
quired rather  than  to  that  which  is  innate^— 
they  are  the  result  of  experience,  of  environmental 
influence,  of  training,  even  though  to  some  extent 
their  energy  may  be  in  part  derived  from  primary 
tendencies  that  have  been  added  to  or  modified  by 
influences  to  which  the  individual  was  subject  in 
the  course  of  development.  The  resistances  in- 
clude many,  if  not  all,  of  those  f unctionings  which 
we  would  set  down  to  conscience.  But  the  point 
to  be  remembered  is  that  they  are  acquired,  the 
result  of  experience. 

It  may  well  be  of  service  to  look  at  these  resis- 
tances from  a  different  angle  from  the  one  to 
which  we  have  become  accustomed.  All  organized 
responses  that  can  be  called  forth  in  both  man  and 
animal,  declare  the  behaviorists,  fall  under  one 
or  the  other  of  two  headings,  instincts  (including 
here  the  simplest  forms  of  reflexes)  and  habits.' 
Both  instinct  and  habit  are  analyzable  into  sim- 
ple congenital  reflexes.  Instinct  is  defined  by  the 
behaviorists  as  ^^a  complex  system  of  reflexes 
which  function  in  serial  order  when  the  organism 
is  confronted  by  certain  stimuli.''  In  exactly  the 
same  terms  do  they  define  habit.  '^  After  habits 
are  perfected  they  function  in  all  particulars  as 
do  instincts.''    The  only  essential  difference  be- 

1  This  must  be  accepted  only  as  a  general  statement  to  which 
there  are  many  exceptions.  Some  of  the  transference  resistances 
with  which  one  has  to  deal  in  the  analysis  may  belong  more  to 
the  instinctive  or  infantile  part  of  the  personality  than  to  that 
part  which  comes  from  training.  • 

s  J.  B.  Watson:    Behavior,  Chap.  VI. 


OBIGIN  OF  EESISTANOES  507 

tween  habit  and  instinct  is,  then,  that  of  origin.^ 
In  instinct  the  ^^ pattern"  (the  nmnber  and  local- 
ization of  the  different  reflex  arcs  involved)  and 
the  ** order''  (the  temporal  relations  of  the  nn- 
folding  of  the  elements  of  the  pattern)  are  in- 
herited, while  in  the  case  of  habit  both  pattern 
and  order  are  acquired  during  the  lifetime  of  the 
individual  All  organized  behavior,  whether  it 
be  ** explicit''  (action)  or  *^ implicit"  (thought  or 
feeling)  is  then  from  the  behaviorist's  point  of 
view,  the  expression  either  of  habit,  of  instinct  or 
of  the  two  combined. 

Some  of  the  important  Freudian  concepts  are 
quite  readily  translatable  into  behavioristic  terms. 
The  unconscious  (i.  e.  that  which  is  primary  in  the 
personality,  the  instinctive  and  infantile)  em- 
braces the  same  functioning^  which  the  behavior- 
ist  calls  'instinct."  Likewise  that  which  is  ac- 
quired, and  which  controls  and  supplements  in- 
stincts and  is  called  ^'  habit  "  by  the  behaviorist,  is 
about  the  same  as  that  which  psychoanalysis  con- 
ceives of  as  belonging  to  the  higher  psychic  sys- 
tems, especially  to  the  foreconscious.  Even 
though  the  correspondence  between  the  "habit" 
of  the  behaviorists  and  the  foreconscious  of  Freud 

iL.  e.  That  which  the  behavioriits  and  which  Freud  would 
call  Instinctiye  is  about  the  aame.  Freud,  however,  uses  the  term 
instiiict  as  the  heading  for  large  groups  of  tendencies,  while  the 
term  impalse  or  wish  applies  to  the  subdiTisions  of  the  group. 
The  behaviorists  would  call  instinctive  these  or  even  finer  sub- 
divisions. I  trust  it  is  dear  that  the  term  habit  as  here  employed 
has  a  much  broader  meaning  than  is  given  to  it  when  in  common 
speech  we  speak  of  a  cigarette  habit  or  the  habit  of  twiddling 
one's  thumbs. 


^» 


508    MORBID  FEABS  AND  COMPULSIONS 

is  not  absolutely  perfect,  yet  for  practical  pur- 
poses they  may  be  thought  of  as  identical. 

This  being  the  case,  it  is  not  difficult  to  see  that 
what  we  are  accustomed  to  call  a  **  resistance  " 
might,  in  most  cases  at  least,  be  called  a  habit.  At 
least  this  is  true  of  all  resistances,  all  repressions, 
that  are  acquired  by  the  individual,  and  not  innate. 
Even  some  of  those  resistances  which  have  an 
hereditary  basis  can  be  regarded  as  instinct  modi- 
fied  or  reenforced  by  habit.^  All  the  repression 
or  inhibitions  which  the  individual  develops  be- 
cause  of  training,  everything  in  conscience  which 
is  acquired,  can  just  as  well  be  regarded  as  an  ex- 
pression of  habit  as  of  the  f  oreconscious  or  of  the 
libido. 

Let  us  ask  ourselves  what  is  the  significance  of 
habit,  with  the  intention  of  thereby  enriching  our 
understanding  of  what  is  meant  by  resistance. 
We  may  answer  this  question  by  considering  an 
example  of  habit.  Young  retriever  dogs,  when 
first  taken  hunting,  will  in  many  instances  chew 
the  birds  they  are  to  retrieve  to  such  an  extent  as 
to  spoil  them.  A  way  to  train  a  dog  not  to  do 
this  is  to  make  him  retrieve  repeatedly  a  dead 
bird  or  a  ball  which  has  been  thrust  full  of  pins. 

iThe  term  ''complex"  does  not  quite  coincide  either  with  in- 
stinet  or  with  habii.  Most  complexes  have  an  instinctiye  basis 
to  which  are  added  the  effects  of  experience  or  training.  Minor 
complexes  are  perhaps  pure  habits  but  the  major  ones  have  both 
instinctive  and  habitual  constituents.  Also,  habit  participates  in 
the  forming  of  fixations  of  instinct,  and  the  infantile  fixations 
though  really  representing  the  effect  of  experience  upon  instinct 
are  considered  from  the  psydioanalytic  standpoint  as  belongimg 
to  the  unconsdoufl. 


4 


SIGNIFICANCE  OF  HABIT         509 

After  the  dog  has  pricked  his  month  a  few  times 
by  shutting  down  upon  such  an  object,  he  learns 
to  carry  it  so  gently  that  in  spite  of  the  pins  he 
will  not  hurt  himself.  He  can  then  be  trusted 
to  carry  with  equal  gentleness  the  game  which  the 
hunter  shoots.  A  habit  has  been  established  by 
the  use  of  pins  which  remains  in  force  and  in- 
hibits the  dog's  original  tendency  to  mouthe  the 
birds  while  retrieving  them.  Because  of  this 
habit  he  now  carries  the  game  m  if  it  contained 
pins. 

Now  this  latter  fact  about  the  habit  is  an  im- 
portant one.  The  behaviorist  seeks  to  formulate 
an  individual's  reactions  in  terms  of  external 
objects  or  conditions,  of  which  the  behavior  is  said 
to  be  a  ^ ^function."  Thus  he  asks  concerning  the 
animal  or  person  to  be  studied,  **What  is  he  do- 
ing?" and  the  reply  is  supposed  to  be  made  in 
terms  of  immediate  external  circumstance.  But 
in  the  case  of  a  dog  whose  original  tendency  was ' 
to  mouthe  game,  but  who  now,  after  the  sort  of 
training  just  described,  carries  it  gently,  the  ques- 
tion ^^What  is  he  doing  f"  cannot  be  completely 
answered  by  the  statement  '^He  is  retrieving  a 
bird."  For  such  an  answer  quite  obviously  does 
not  tell  the  whole  story.  He  is  retrieving  a  bird 
in  a  (for  him)  special  manner,  namely,  as  if  it 
contained  pins.  His  behavior  is  a  function  of 
something  more  than  the  bird  he  at  the  moment 
holds  in  his  mouth.  It  is  partly  determined  by 
past  experience,  without  which  he  would  be  still 
mouthing  the  game.  In  other  words,  we  cannot 
adequately  formulate  his  behavior,  when   this 


510    MORBID  FEARS  AND  COMPULSIONS 

habit  is  involved,  if  we  employ  terms  only  of  tiie 
present  To  make  an  adequate  picture  of  the 
significance  of  the  habit  requires  us  to  draw  in  it 
phantoms  of  past  pins. 

Now  much  the  same  thing  applies  to  habits  gen- 
erally.^ Their  significance  cannot  be  expressed 
without  historical  references.  The  question 
'^What  is  he  doingf "  cannot,  when  it  is  a  case  of 
habit,  be  answered  satisfactorily  without  bring- 
ing in  terms  of  the  past  experiences  which  jwere 
instrumental  in  integrating  the  reflexes  which 
constitute  the  habit.  In  short,  in  those  responses 
of  an  individual  which  belong  to  habit,  he  is  be- 
having very  much  as  if  he  were  stiU  surrounded 
by  those  same  external  circumstances  to  which  the 
actions  which  eventually  became  habitual  were 
originally  an  adaptation^ . 

The  Bible  says:  ** Train  up  a  child  in  the  way 
he  should  go  and  when  he  is  old  he  will  not  depart 
from  if  This  is  the  equivalent  of  saying: 
'^Devise  a  system  of  rewards  and  punishments, 
of  praise  and  blame,  which  will  lead  your  child  to 
react  for  a  period  in  the  wa3rs  that  seem  to  you 
best,  and  these  ways  of  reacting  will  eventually 
become  habits  which  he  will  retain  throughout  his 
life.  In  other  words  he  will,  even  after  you  are 
dead  and  buried,  continue  to  act,  to  feel  and  to 
think  in  response  to  certain  stimuli,  AS  IF  you 
were  stUl  watching  over  him;  AS  IP  your  orig- 

1  Naturally  I  am  tMnking  in  this  connection  only  of  acnaori 
motor  habits — not  of  the  sort  which  depend  on  some  artiflctally 
produced  changes  in  the  chemistry  of  the  body  such  aa  oeeor  with 
the  morphine  or  tobacco  habit. 


SIGNIFICANCE  OP  HABIT         511 

incU  system  of  rewards  and  punishments  were 
still  in  force.^  To  be  sure  he  will  soon  cease  to 
interpret  his  own  behavior  in  any  snch  light. 
When  the  habits  that  yon  instilled  function  in  his 
adult  life,  he  will  very  likely  rationalize  his  ac- 
tions, thoughts  or  feelings  by  saying  for  instance 
that  now  he  has  become  a  man,  he  sees  that  his 
parents  were  ** right'*  in  their  training  of  him  or 
that  he  believes  or  behaves  in  this  or  that  way 
because  one  ** ought  to"  or  because  his  ** con- 
science prompts  it/'  But  the  whole  business  is 
but  the  manifestation  of  habit,  or  instinct  plus 
habit.* 

iMany  parents  have  been  grievously  disappointed  to  find  that* 
after  they  have  devoted  themselves  assiduously  to  training  up  a 
child  "in  the  way  he  should  go,"  he  departed  from  it  with  the 
greatest  dispatch  as  soon  as  he  left  the  parental  fireside  or  ceased 
greatly  to  fear  parental  punishment.  But  this  by  no  means 
alters  the  fact  that  the  biblical  statement  expresses  a  perfectly 
correct  general  principle,  and  one  which  holds  good  to  an  even 
greater  extent  than  superficial  observation  would  consider  pos*- 
sible.  The  general  principle  is  that  the  effects  of  training  tend 
to  be  permanent,  whether  they  be  in  the  direction  of  the  way  the 
child  should  go,  or  of  the  way  he  should  not  go.  Many  of  the 
parental  disappointments  of  the  sort  described  depend  upon  the 
fact  that  the  efforts  that  were  made  to  train  the  child  in  the  way 
he  should  go  were  really  training  him  in  very  different  directions, 
for  example,  to  react  with  feelings  of  hate,  rebellion  and  sus- 
picion to  all  stimuli  that  would  come  under  the  head  of  "au- 
thority." 

si  know  very  well  how  difficult  it  is  for  one  to  recognize  in 
himself  the  ftmctioning  of  deeply  ingrained  habits  or  instincto- 
habits  for  what  they  really  are.  The  more  fully  a  given  response 
is  the  product  of  habit,  or  of  habit  grafted  on  an  instinct,  the 
more  likely,  generally  speaking,  is  the  individual  to  rationalize 
it  into  something  else  and  thus  to  believe  sincerely  that  he  is 
acting  in  this  or  that  way  because  it  is  "right"  to  do  so,  or  for 
some  similar  reason.    The  people  of  this  country,  for  instance. 


514    MORBID  FEARS  AND  COMPULSIONS 

iiig  off  stimuli.  The  question,  What  is  he  daingf 
when  acquired  organized  responses  are  involved 
(habit  or  resistance)  cannot  be  fuUy  answered 
without  reciting  the  history  of  the  experiences 
which  produced  the  integraiums  now  functionat- 
ing. 

Now  in  the  case  of  the  dog  in  whom  there  has 
been  bnilt  np,  by  the  use  of  pins,  a  habit  or  re- 
sistance which  inhibits  his  original  tendency  to 
monthe  game,  we  can  describe  his  behavior  in 
objective  terminology  by  introducing  the  words 
as  if.  We  take  account  of  his  habit  and  its  his- 
tory by  saying  that  he  now  retrieves  game  as  if 
he  were  trying  to  avoid  getting  his  mouth  hurt 
A  step  beyond  this,  which  would  bring  us  nearer 
to  the  psychoanalytic  way  of  looking  at  thingps, 
would  be  to  say  he  was  behaving  as  if  he  thought 
the  game  contained  pins,  as  if  he  desired  to  avoid 
getting  his  mouth  hurt.^  In  answering  the  ques- 
tion. What  is  he  doing  t  we  have  now  introduced 
the  concepts  of  thinking,  of  wishing  and  of  ideas. 
Now  the  psychoanalytic  way  of  answering  such 
questions  goes  still  further  than  that  just  indi- 
cated. In  matters  of  human  behavior  which  in- 
volve the  functionating  of  a  habit,  or  a  resistance, 
the  answer  runs  not  *^ as  if  he  thought^'  nor  as  if 
he  wished''  so  and  so,  but  rather  **  he  does  think 
it,  he  does  desire  it,"  but  in  the  main  ''  uncon- 
sciously/' And  this  is  not  purely  conceptional 
nor  merely  a  convenient  way  of  describing.    As 

1  This  way  of  expressing  the  facts  Is  quite  permissible  eren 
though  we  may  know  that  the  dog  is  incapable  of  "thinking," 
in  any  ordinary  human  sense,  anything  of  the  kind. 


SIGNIFICANCE  OF  RESISTANCE    515 

onr  previous  chapters  have  indicated,  the  assumed 
unconscious  thinking  or  wishing  can  with  all  rea- 
sonable certitude  be  demonstrated  to  have  existed, 
even  though  the  evidence  is  not  wholly  direct. 
The  history  of  the  past  experiences  which  first 
called  forth  the  responses  which  eventually  be- 
came integrated  as  habit  or  resistance  is  pre- 
served as  memory  traces  in  the  mind  of  the  indi- 
vidual Some  of  these  records  are  foreconscious 
and  subject  to  voluntary  recall ;  others  are  uncon- 
scious and  can  be  reproduced  only  in  the  course 
of  an  analysis.  But  the  point  is,  that  there  is 
contained  in  the  individuaPs  own  mind  that  same 
historical  material  which,  as  we  have  said,  is  re- 
quired to  express  the  full  significance  of  any  item 
of  acquired  organized  behavior — ^action,  thought, 
or  feeling. 

It  is  now  to  be  seen  that  we  have  stumbled  upon 
an  answer  to  the  questions  from  which  we  set  out. 
The  filling  out  of  gaps  of  memory  is  nothing  else 
than  a  process  of  bringing  to  the  surface  the  his- 
torical records  of  the  experiences  instrumental  in 
integrating  the  systems  of  habits  or  resistances 
which  are  now  functionating.  It  supplies  the  pa< 
tient  with  the  data  which  are  required  for  him  to 
see  the  whole  meaning  of  his  present  behavior, 
implicit  and  explicit.  It  shows  him  what  he  is 
doing,  in  the  fullest  possible  sense.  We  have  said 
that  when  acquired  integrations  are  functionating 
the  behavior  of  the  individual  is  the  same  as  if 
there  were  still  present  the  original  conditions 
which  first  called  forth  these  responses.  He  is 
reacting  as  if  surrounded  by  phantoms  of  the  past. 


516    MORBID  FEAES  AND  COMPULSIONS       '^ 

though  this  he  himself  does  not  recognize.  The 
filling  out  of  the  gaps  of  memory  which  takes 
place  in  the  analysis  allows  him  to  see  this,  and 
to  appreciate  the  significance  of  that  part  of  his 
present  acting,  feeling  or  thinking  for  which  hahit 
is  responsible.  This,  apparently,  is  what  cares 
him.  The  reducing  of  acquired  integrations  to 
the  terms  of  the  original  experiences  frees  the 
individual  from  their  automaticity  and  enables 
him  to  adapt  to  the  facts  of  the  present  instead, 
as  previously,  to  phantoms  of  the  past.  When  he 
knows  in  full  detail  what  he  really  is  doing,  then 
he  can  do  otherwise  if  his  inner  needs  and  ex- 
ternal circumstances  demand  it.  Habit,  write 
Dewey  and  Tufts,*  is  a  stage  "of  unconscious  ac- 
tivity along  the  lines  set  previous  action.  Con- 
sciousness thus  ^  occupies  a  curious  middle  ground 
between  hereditary  reflex  and  automatic  activities 
upon  the  one  hand  and  acquired  habitual  activi- 
ties on  the  other.'*  Where  the  original  equip- 
ment of  instincts  fails  to  meet  some  new  situation, 
when  there  are  stimulations  for  which  the  system 
has  no  ready-made  response,  consciousness  ap- 
pears. It  selects  from  the  various  responses  those 
which  suit  the  purpose,  and  when  these  responses 
have  become  themselves  automatic,  habitual,  con- 
sciousness 'betakes  itself  elsewhere  to  points 
where  habitual  accommodatory  movements  are  as 
yet  wanting  and  needed.'  To  apply  this  to  the 
moral  development  we  need  only  to  add  that  this 

1  Dewey  and  Tufts:     Ethici»  page  9. 
sAngell:    Peycfaology,  page  69. 


OVEECOMINO  EESISTANCES       517 

process  repeats  itself  over  and  over.''  The 
analysis  is  exactly  the  reverse  of  this.  By  it, 
consdonsness,  which  had  '^betaken  itself  else- 
where'' is  brought  back  to  the  points  at  which 
'^responses  which  have  become  themselves  auto- 
matiCy  habitual"  had  origin;  the  individual  is  al- 
lowed to  deliberate,  to  value,  to  choose  anew. 
New,  better,  more  intelligent  ways  of  reacting  to 
present  situations  are  thus  opened  up  to  him  to 
replace  those  in  his  repertoire  of  ready-made 
automatic  responses,  which,  because  they  were 
integrated  when  his  intellect  had  not  yet  reached 
its  maturity,  and  when  his  capacities  for  analyz- 
ing and  choosing  were  especially  limited,  do  not 
fully  utilize  his  adaptive  possibilities  or  allow  him 
to  put  forth  his  actual  best 

The  overcoming  of  resistances,  as  was  indicated 
in  the  beginning,  is  inseparable  from  and  almost 
identical  with  the  filling  out  of  the  gaps  of  mem- 
ory. The  resistances,  which  maintain  the  repres- 
sion against  which  the  instinctive  forces  struggle, 
exist  as  it  were  in  layers.  The  first  resistances 
that  present  themselves  in  the  analysis  are  over- 
come by  explaining  them;  by  filling  out  what  is 
missing  from  the  patient's  consciousness  to  give 
him  a  full  view  of  their  significance ;  in  short,  by 
showing  the  patient  what  he  really  is  doing  when 
they  act.  In  the  breaking  up  of  resistances  the 
personal  association  of  the  patient  with  the  phy- 
sician plays  an  important  part.  The  role  of  the 
analyst,  as  Ferenczi  says,  is  that  of  ''a  catalytic 
ferment  that  temporarily  attracts  to  itself  the  af- 


518    MORBID  FEAES  AND  COMPULSIONS 

fects  split  off  by  the  dissection/'  ^  With  one  re- 
sistanee,  or  one  layer  of  resistances,  out  of  the 
way  there  becomes  accessible  new  historical  ma- 
terial which  is  serviceable  for  filling  out  the  gaps 
of  memory  that  will  lead  the  patient  to  an  under- 
standing of  the  next.  Eventually,  if  this  process 
is  continued  far  enough,  the  purely  instinctive 
and  infantile  levels  are  reached.  Then  with  his 
unnecessary  internal  inhibitions  dissolved  the  pa- 
tient can  make  the  adaptations  that  shall  give  him 
a  maximum  of  wish-fulfilhnent,  and  do  away  with 
the  damming  up  of  the  libido,  without  at  the  same 
time  overstepping  the  requirements  for  a  moral 
and  socially  commendable  life.  Morality  and 
wishf  ulfillment  are  both  easy  and  compatible  when 
one's  problems  are  simplified  by  the  elimination 
of  unreality  and  reduced  solely  to  the  question  of 
adaptation  to  external  facts. 

In  order  that  we  be  perfectly  clear  about  all  this 
it  may  be  well  to  make  some  concrete  applications. 
The  orthodox  Jew  reacts  negatively  to  hanu  If 
he  were  compelled  to  eat  it  by  force,  he  would 
doubtless  be  able  to  swallow  ham  but  not  however 
without  some  slight  feeling  of  shrinking  or  of 
guilt.  Such  a  reaction  is  not  instinctive,  but  the 
result  of  training,  of  earlier  experience.  In  other 
words  it  is  the  expression  of  a  habit.  But  in  per- 
haps most  cases,  the  individual  himself  would  not 
spontaneously  recognize  this.    If  he  were  asked 

iFerencd,  ''CkmtribotioiiB  to  PsyclioaiialyBifly''  p.  84.  He  eon- 
tinuee^  "In  a  technically  correct  psycho-analyais  the  bond  thus 
formed  is  only  a  loose  one,  the  interest  of  the  patient  being  led 
back  as  soon  as  possible  to  its  original,  oovered-over  aonrcsa  and 
brought  into  permanent  oonneetion  with  them." 


EXAMPLE  OF  HABIT  519 

why  he  so  reacted  to  ham,  he  would  say  it  is  be- 
cause ham  is  Trafe  and  it  is  a  sin  to  eat  it.  But 
this  would  be  attempting  to  formulate  his  be- 
havior in  terms  only  of  the  present,  which  is  quite 
inadequate  to  express  the  full  significance  of  the 
habit  which  is  functionating.  He  would  not  know 
what  he  was  doing  in  any  full  sense  of  the  phrase. 

But  I  have  been  told  by  certain  Jews  who  were 
orthodox  as  children  but  later  abandoned  their  old 
religion  in  favor  of  some  other,  or  no  religion  at 
all,  that  their  first  attempts  to  eat  ham  were  at- 
tended by  considerable  feelings  of  aversion,  and 
a  vague  sense  of  guilt,  and  this  despite  the  fact 
that  they  were  fully  convinced  that  ham  is  a  per- 
fectly wholesome  food,  and  that  there  was  no  rea- 
son at  all  why  they  should  not  eat  it.  In  this 
case  the  habit  was  left  functionating  in  a  state  of 
greater  or  less  isolation  by  the  individual's  per- 
sonality having  passed  on  to  newer  developmental 
phases.  But  these  men,  however,  knew  something 
more  of  what  the  reaction  meant  (of  what  they 
were  doing)  than  was  true  in  the  first  cases. 
They  would  have  said  themselves:  "I  feel  this 
way  because  of  my  bringing  up.  It  is  a  matter 
of  habit  or  training  which  I  have  not  yet  over- 
come.'* But  this  knowledge  would  not  go  very 
far  toward  breaking  up  the  integration.  The 
history  of  the  integration  would  still  be  incom- 
plete. 

Now  these  particular  Jews  that  I  have  in  mind 
did  eventually  overcome  their  habit  of  reacting 
negatively  to  ham  by  the  simple  process  of  con- 
tinuing to  eat  it.    They  never  knew  precisely 


520    MOBBID  FEABS  AND  COMPULSIONS 

what  were  the  original  experiences  which  caused 
the  habit  to  be  integrated.  But  I  can  very  well 
imagine  that  there  are  other  cases  where  in  spite 
of  the  individual's  being  convinced  intellectually 
that  ham  is  something  altogether  desirable  to  eat, 
and  in  spite  of  his  wishing  to  eat  it,  the  old  habit 
was  not  overcome,  but  continued  to  function  in- 
definitely. Now  an  enormous  number  of  habits 
we  once  have  possessed  have  spontaneously  ceased 
to  function  when,  as  we  grow  older,  they  ceased 
to  serve  any  adaptive  purpose.  Were  this  not  the 
case  we  would  never  be  able  to  adapt  ourselves  to 
any  later  environment  that  was  not  almost  identi- 
cal with  that  in  which  we  grew  up.  But  other 
habits  in  many  persons  persist  long  after  they 
have  outlived  their  usefulness,  and  when  instead 
of  being  of  advantage  to  the  individual  they  are 
of  great  disadvantage  both  in  themselves  and  by 
way  of  interfering  with  his  making  the  new 
adaptations  that  nught  readily  come,  once  these 
old  integrations  were  out  of  the  way.  Such  is 
the  case  with  the  neurotic  He  has  been  unable 
to  shake  off  the  old  habits  of  childhood  in  favor  of 
the  new  ones  that  would  adapt  him  to  adult  life. 
In  this  case  the  analysis  may  intervene,  and  by 
breaking  up  the  old  integrations  for  him,  allow 
him  to  express  his  instinctive  energies  in  the  man- 
ner best  adapted  to  the  requirements  of  his  par- 
ticular place  in  life. 

If  in  the  case  of  a  Jew  who  continues  the  habit 
of  reacting  negatively  to  ham  after  he  had  aban- 
doned his  religion  and  really  desired  to  eat  ham,  it 
should  become  highly  essential  that  the  habit  be 


UNCONSCIOUS  MEMOEIES         521 

overcome  artificially,  he  would  have  to  be  made 
to  recall  the  actual  experiences  of  his  childhood 
which  had  brought  the  habit  into  existence,  to 
be  shown,  in  other  words,  what  he  was  doing. 
When  these  memories  were  recalled,  the  uncon- 
scious elements  belonging  to  the  habit  rendered 
conscious,  he  would  then  perhaps  see  that  his  reac- 
tion was  only  to  a  most  limited  extent  a  function  of 
what  ham  is  actually,  but  perhaps  much  more  so 
a  function,  let  us  say,  of  his  father — ^L  e.  that  what 
originally  caused  him  to  avoid  those  things  called 
Traf  e  was  that  he  was  scolded  and  punished  by 
his  father  when  he  did  not.^  When  then  he  could 
see  clearly  that  his  negative  reaction  to  ham  was 
really  conditioned  by  an  unconscious,  but  still 
operative,  fear  of  punishment  from  his  father,  it 
would  without  doubt  cease.' 

In  the  case  of  this  habit,  as  that  of  any  item  of 
acquired  organized  behavior,  the  reaction  of  the 
individual  represents  a  precipitate  from  certain 
past  situations  and  experiences  which  continue  to 
live  as  present  ones  in  his  unconscious  memories. 
While  these  memories  remain  unconscious,  his 
response  to  such  present  situations  as  contain 
stimuli  for  the  constellation  is  for  the  most  part 
a  blind,  unreasoned  and  automatic  one.  In  other 
words,  responses  which  come  from  habit  do  not 
take  advantage  of  the  possibilities  for  other  and 

^  Of  oourse  the  history  of  the  hute^ratioii  of  the  habit  could  not 
be  as  simple  as  this,  but  what  I  have  said  is  suiBdent  for  our 
immediate  purposes. 

sThis  fear  belongs  to  the  foreoonscious  rather  than  to  the 
unoonsoioua  proper. 


522    MOBBID  PEABS  AND  COMPULSIONS 

perhaps  more  suitable  and  intelligent  responses 
offered  by  the  increases  in  knowledge,  experience 
and  intellectual  development  which  have  taken 
place  in  the  individual  subsequent  to  the  time  the 
habit  was  formed.  Habit  is  static,  unprogressive, 
retardative.  But  by  bringing  the  unconscious 
memories  to  consciousness,  by  showing  the  incU- 
vidual  in  full  exactly  what  he  is  doing,  there  is 
quite  understandably  restored  to  him  adaptative 
flexibility  and  the  opportunity  to  exchange  the 
automatic  habitual  response  for  action  from  re- 
flection and  deliberation,  which  shall  eliminate 
unreality  and  take  advantage  of  whatever  he  has 
gained  from  maturity  and  increased  knowledge 
and  experience  in  the  period  succeeding  the  for- 
mation of  the  habit.  We  miss  the  full  significance 
of  this  discussion  of  habit  unless  we  keep  con- 
tinually in  mind  that  there  are  habits  of  thought 
and  feeling  just  as  well  as  habits  of  conduct 

I  will  now  attempt  to  illustrate  some  of  our 
earlier  points  by  reference  to  the  analysis  of  a 
particular  case,  drawing  meanwhile  some  par- 
allels between  it  and  the  problems  suggested  by  the 
matter  of  the  Jews'  reaction  to  ham. 

A  man  came  to  me  suffering  from  a  mild  neuro- 
sis. He  had,  as  he  expressed  it,  lost  confidence  in 
himself.  A  feeling  of  uncertainty  attended 
everything  he  did ;  for  instance  he  coiQd  no  longer 
feel  satisfied  that  his  judgment  of  business  mat- 
ters was  correct.  He  was  continually  apprehen- 
sive of  making  mistakes  that  would  have  some 
sort  of  serious  consequences.  He  could  not  do  his 
work  either  with  the  ease  or  with  the  enthusiasm 


A  CASE  OF  INHIBITION  523 

he  had  had  formerly.  In  addition  to  this  he  felt 
somewhat  depressed  the  greater  part  of  the  time. 
Everything  seemed  to  have  lost  interest  for  him. 
He  could  not  enjoy  himself  at  the  theater,  in  read- 
ing or  in  any  of  the  other  recreations  he  had  pre- 
viously cared  about.  His  trouble,  though  not  a 
serious  one,  was  very  unpleasant  and  hampering 
and  he  had  been  unable  to  shake  it  off. 

He  very  soon  said  that  he  himself  had  felt  that 
his  difficulties  were  somehow  connected  with  the 
sexual  problem.  His  symptoms  had  come  on 
gradually  toward  the  end  of  the  first  year  after 
his  marriage.  He  frankly  admitted  that  his  home 
life  was  not  in  just  the  state  he  thought  it  should 
be.  Not  that  there  was  any  open  friction  between 
him  and  his  wife,  or  that  he  had  any  just  reason 
for  complaining  of  anything  in  her  attitude 
toward  him.  She  was  a  very  beautiful,  intelli- 
gent, refined  and  good  tempered  woman,  who,  he 
felt,  should  make  an  ideal  wife  and  completely 
satisfy  him.  Nevertheless  he  was  not  content. 
He  admired  and  respected  her  enormously,  and 
had  for  her  a  very  deep  affection.  On  the  other 
hand  she  did  not,  as  he  expressed  it,  appeal  to 
him  in  a  ** physical  way."  In  spite  of  her  per- 
sonal beauty  he  felt  little  passion  towards  her  and 
their  sexual  relations  gave  him  none  of  the  full 
sense  of  gratification  and  enjoyment  that  he  had 
known  in  his  premarital  experiences  with  other 
womeiL  Why  this  should  be  he  could  not  un- 
derstand. He  had  sometimes  told  himself  that  if 
his  wife  were  more  passionate  he  would  enjoy 
himself  better,  yet  at  the  same  time  he  had  to 


524    MOBBID  FEABS  AND  COMPXJLSIONS 

acknowledge  that  on  the  one  hand  she  was  far 
from  f rigid,  and  on  the  other  that  in  his  premar- 
ital affairs  he  had  experienced  full  enjoyment 
with  women  who  showed  even  less  signs  of  pas- 
sion than  she.  Bnt  at  any  rate,  and,  as  it  seemed 
to  him,  in  consequence  of  his  lack  of  fnll  sexnal 
satisfaction  with  her,  he  had  become  more  and 
more  subject  to  a  sense  of  unreasonable  irritation 
against  his  wife  and  a  certain  distaste  for  her 
society.  It  had  seemed  to  him  that  he  was  be- 
coming less  and  less  in  love  with  her,  and  that  at 
the  same  time  this  was  somehow  his  own  fault 
Meanwhile  he  had  found  his  mind  continually 
dwelling  on  erotic  phantasies  about  other  women, 
either  those  he  had  known  before  his  marriage  or 
others  he  had  met  since.  Sometimes  they  were 
about  perfect  strangers,  as,  for  instance,  some  at- 
tractive looking  woman  he  might  see  on  the  street 
At  times  he  found  himself  wishing  that  he  had  not 
married  or  were  again  free  to  pursue  some  of 
these  women  who  seemed  to  have  a  stronger  sex- 
ual appeal  to  him  than  his  wife.  Such  thoughts 
distressed  him  profoundly.  He  felt  that  he  ought 
to  be  perfectly  satisfied  with  his  wife  and  that 
longings  and  phantasies  concerning  other  women 
should  not  enter  his  mind  at  all.  He  had  made 
every  effort  to  be  content  with  his  marriage  and  to 
resist  these  outside  appeals,  but  even  though  he 
knew  he  had  done  Ms  best,  he  continually  felt 
guilty  for  not  having  succeeded.  He  had  sus- 
pected, quite  correctly,  that  his  distrust  of  him- 
self in  business  affairs,  his  lack  of  interest  and  his 
depression  were  merely  diffusions  of  feelings  of 


A  CASE  OF  INHIBITION  525 

self-distnist  and  dissatisfaction  that  really  arose 
in  connection  with  his  home. 

The  story  which  this  man  related  is  indeed  a 
very  common  one,  with  the  analytic  significance  of 
which  I  was  familiar  from  previously  studied 
cases.  The  patient  mentioned  during  one  of  his 
early  visits  that  he  had  not  known  anything  about 
intercourse  until,  when  he  was  some  ten  years 
oldy  another  boy  had  described  it  to  him,  saying 
that  was  the  way  all  babies  were  made.  Like 
many  other  children  in  similar  circumstances,  he 
had  refused  to  believe  this  explanation  of  repro- 
duction, saying:  **That  may  be  true  of  some 
people,  but  I  know  my  mother  would  never  have 
done  such  a  dirty  thing. ' ' 

When  he  had  related  to  me  this  incident,  I  took 
it  as  a  text  upon  which,  with  certain  other  ma- 
terial not  mentioned  here,  to  set  forth  the  follow- 
ing explanation  of  his  difficulties  with  his  wife. 
His  apparent  lack  of  passion  toward  her  and  his 
inability  to  experience  full  satisfaction  in  their 
sexual  relations  was  not,  I  said,  the  result  of  a 
real  absence  of  sensual  appeal,  but  was  produced 
by  an  inhibition,  a  repression.  The  repressing 
or  inhibiting  agent  was  a  habit,  complex  or  resist- 
ance (whichever  one  might  choose  to  call  it)  which 
had  been  integrated  by  certain  incidents  and  edu- 
cational influences  to  which  he  had  been  subject 
in  the  course  of  his  bringing  up.  Though  the 
details  were  lacking,  it  was  possible  to  describe  in 
general  terms  how  this  integration  had  been 
formed.  No  doubt,  as  a  small  child,  he  had  gotten 
into  trouble  when  he  showed  some  infantile  sexual 


526    MOEBID  FEAES  AND  COMPULSIONS 

interest  in  his  mother.  There  were  probably  a 
large  number  of  as  yet  nnremembered  incidents 
which  led  him  to  feel  that  all  erotic  interests  were 
"  dirty  *'  and  **bad''  and  therefore  offensive  to 
and  to  be  concealed  from  his  mother  and  all 
"good*'  women,  who,  naturally,  were  conceived  of 
as  having  no  feelings  of  so  base  a  sort.  In  short 
through  training  there  had  been  built  up  a  re- 
sistance, or  inhibition,  a  habit,  in  short)  which 
caused  him  to  react  toward  his  mother  in  a  way 
quite  different  from  what  would  have  been  the 
case  had  he  been  left  perfectly  free  to  follow  his 
primitive  holophilic  impulses. 

Now  it  was  this  habit  or  complex  which  was 
responsible  for  his  lack  of  complete  satisfaction  in 
his  sex  relations  with  his  wife.  For,  not  unnat- 
urally, it  was  brought  into  action  not  only  by  the 
mother  herself  but  by  other  **good''  women  who 
had  certain  traits  in  common  with  her  which  pro- 
duced an  unconscious  identification.  Thus  such 
qualities  as  virtue,  refinement  and  culture  which 
caused  him  to  hold  a  woman  in  high  esteem  did 
not  reenf orce  the  effect  of  her  physical  charms  to 
excite  all  his  holophilic  impulses,  but  served 
rather  to  bring  more  or  less  fully  into  action  the 
old  repressive  integration  and  thus  to  ifAibit  in 
some  degree  the  more  sensual  components  of  love. 
And  just  as  in  the  case  of  the  Jews  I  have  men- 
tioned, the  habit  of  reacting  negatively  to  ham 
continued  even  after  they  were  convinced  intel- 
lectually that  it  is  a  perfectly  wholesome  food, 
so  in  this  patient  the  inhibitive  reaction  upon  his 
sensual  erotic  impulses  continued  to  be  exerted 


A  CASE  OF  INHIBITION  527 

even  after  he  had  ceased  intellectaally  to  think 
that  a  display  of  passion  would  be  offensive  to  the 
good  woman  (his  wife)  and  could  not  meet  with  a 
corresponding  excitement  in  her. 

This  explanation,  when  I  had  outlined  it  to  the 
patient  he  said  impressed  him  greatly  and  he  felt 
convinced  that  it  was  entirely  correct  In  sub- 
stantiation of  it  he  remarked  that  now  he  came  to 
think  of  the  matter  he  realized  that  the  women 
with  whom  in  his  premarital  affairs  he  had  ex- 
perienced a  high  degree  of  passion  and  full  sexual 
enjoyment  were  invariably  ones  whom  he  had  rea- 
son to  think  ^^bad''  even  before  he  made  advances 
to  them.  Furthermore,  when  he  felt  attracted  by 
some  woman  he  might  pass  on  the  street,  it  was 
always  by  one,  as  he  now  realized,  who  used  a 
good  deal  of  paint  and  powder,  dressed  flashily, 
showed  her  legs,  or  had  some  suggestion  of 
^^sportiness"  about  her  which  indicated  to  his 
mind  that  she  was  not  overburdened  with  virtue 
nor  likely  to  be  offended  by  any  sort  of  sexual  dis- 
play, provided  it  were  made  under  favorable  cir- 
cumstances. 

Now  in  the  case  of  the  Jew  reacting  negatively 
to  ham  after  he  had  ^ven  up  his  reli^on,  the 
individual  was  aware  in  a  general  way  of  why  he 
so  reacted.  He  would  have  said,  if  any  one  had 
asked  him:  '^The  reason  I  feel  this  way  is  be- 
cause of  my  bringing  up.  It's  a  matter  of  habit 
or  training. '*  But  in  the  case  of  this  patient,  the 
reason  for  the  inhibition,  or  indeed  the  fact  of  its 
existence,  was  not  understood  until  I  had  ex- 
plained it  to  him.    But  after  he  had  heard  the  ex- 


528    MORBID  PEABS  AND  COMPULSIONS 

planatioiiy  his  state  was  analogous  to  that  of  the 
Jew.  He  too  could  say  and  believe,  ^' It's  a  mat- 
ter of  bringing  up,  of  habit  and  training/'  but 
without  being  able  to  remember  any  but  a  small 
number  of  the  incidents  by  which  he  was  trained. 

The  Jews  who  abandoned  their  religion  lost 
their  n^ative  reaction  to  ham  through  their  con- 
tinuing to  eat  it.  The  old  habit  spontaneously 
ceased  to  functionate.  But  this  was  not  par- 
alleled in  the  case  of  the  inhibition  suffered  by 
this  patient.  The  explantion  given  above  had  the 
effect  of  making  his  sexual  relations  with  his 
wife  slightly  less  unsatisfactory,  but  the  change 
was  by  no  means  profound.  The  old  integration 
continued  in  operation  despite  all  the  changes 
which  had  taken  place  in  the  patient's  conscious 
thinking  since  the  period  in  which  it  was  formed 
and  in  the  course  of  the  analysis.  He  went  right 
on  reacting  towards  his  wife  in  the  same  manner 
(if  not  to  the  same  degree)  that  he  had  been 
trained  to  react  toward  his  mother. 

Now  the  analytic  explanation  I  had  given  him 
had,  in  a  certain  sense,  rendered  conscious  some- 
thing that  had  previously  been  unconscious.  He 
knew  that  there  was  an  inhibition  exerted  upon 
the  sex-impulses  directed  toward  his  wife,  and, 
in  a  general  way,  what  this  inhibition  sprang  from 
— ^that  is  to  say,  from  the  training  he  had  received 
in  childhood,  from  various  incidents  of  the  past 
But  this  explanation  had  merely  placed  him  in 
about  the  same  position  as  that  of  the  Jew  who 
continues  a  negative  reaction  to  ham  even  when, 
having  abandoned  his  old  religion,  he  desires  to 


A  CASE  OF  INHIBITION  529 

eat  ham  and  knows  of  no  reason  why  he  should 
not.  The  analysis  had  simply  formulated  the  pa- 
tient's problem,  had  diagnosticated  his  situation. 
The  problem  still  remained  to  be  solved,  the  trou- 
ble whioh  was  diagnosed  had  yet  to  be  cured. 

How  then  was  this  old  habit  or  integration 
which  still  continued  to  functionate  eventually 
broken  upf  Obviously  the  integration  was  pro- 
duced by,  and  the  continued  habit  was  an  effect 
of,  certain  earlier  experiences  which  we  would  in- 
dude  under  the  head  of  'draining."  The  num- 
ber of  individual  experiences  which  had  been  in- 
strumental in  fonning  the  integration  quite 
obviously  must  have  been  large.  And  the  same 
might  be  said  of  those  experiences  of  religious 
training  and  family  life  which  produced  in  the 
Jew  a  feeling  of  aversion  to  ham.  But  in  each 
case  only  a  small  number  of  the  integrating  ex- 
periences could  be  spontaneously  recalled  in  de- 
tail by  the  individual  and  observation  goes  to  show 
that  those  which  can  be  recalled  are  by  no  means 
invariably  the  most  important  or  the  ones  which 
had  the  prof oundest  effects.  In  short  the  mem- 
ories and  records  of  the  experiences  which  had 
served  to  build  up  these  habits  still  remained  in 
great  measure  unconscious.  Now  the  way  that 
the  analysis  eventually  breaks  up  these  integra- 
tions or  complexes  and  frees  the  individual  from 
the  habits  of  reacting  that  have  outlived  their 
usefulness  is,  as  we  have  said,  by  reducing  them 
to  the  original  individual  experiences  through 
which  they  were  buUt  up.  They  have,  in  one  way 
or  another,  to  be  recalled.    The  individual  is,  as 


630    MOEBID  FEAES  AND  COMPULSIONS 

it  were,  taken  back  in  memory  to  the  original  ait- 
nations,  allowed  to  review  them  in  the  light  of 
new  knowledge  and  to  start  from  them  afresh  in 
snch  a  way  as  to  form  new  integrations  better 
adapted  to  the  demands  of  adnlt  existence  than 
were  the  old. 

One  conld,  then,  divide  the  analytic  work,  on 
theoretical  grounds,  into  two  parts:  the  ^ag- 
nostic, which  discovers  what  complexes,  resist- 
ances or  habits  are  responsible  for  the  patient's 
troubles  and  which  formulates  his  problems  for 
him,  and  the  disintegrative  or  analytic  proper, 
which  breaks  up  the  undesirable  habits  or  com- 
plexes by  making  the  patient  re-live  the  original 
experiences  by  which  they  were  built  up.  As  a 
matter  of  fact,  in  practice  there  is  no  such  dis- 
tinction possible.  Both  diagnostic  and  disinte- 
grative analysis  occur  together  and  are  indis- 
tinguishable. Nevertheless  the  division  I  have 
suggested  has  a  certain  value.  Some  mild  cases 
and  some  of  the  elements  involved  in  severe 
cases  require  little  more  than  a  diagnostic  anal- 
yjais.  Once  the  problem  is  clearly  formulated 
for  the  patient  he  may  be  able  to  meet  it  un- 
aided further,  just  as  the  Jew  would  overcome 
his  resistance  to  ham  by  simply  continuing  to 
eat  it.  Perhaps  a  larger  part  of  the  analytic 
cure  than  we  are  wont  to  realize  is  brought  about 
in  this  way.  In  fact  if  every  troublesome  com- 
plex and  integration  required  as  detailed  analysis 
as  do  some  of  the  most  important  ones,  the 
already  lengthy  process  of  an  analjrtic  treatment 
would  be  really  endless.    In  the  case  of  Miss 


BEMEMBEBINO  531 

for  instance,  an  adjustment  was  brought 
about  and  a  cure  resulted  from  an  analysis  that 
was  more  largely  diagnostic  than  disintegrative. 
None  of  her  complexes  were  reduced  to  the  terms 
of  the  original  integrating  experiences  with  any- 
thing like  the  fullness  of  detail  with  which  I  am 
familiar  from  cases  of  a  more  severe  type,  and 
which  is  required  in  them  to  bring  about  a  cure. 

How  then  is  the  distiutegrative  living-over- 
again  of  the  earlier  complex-producing  experi- 
ences accomplished?  Apparently  in  two  essen- 
tially different  ways,  the  one  by  the  patient  *8  di- 
rectly recalling  these  past  experiences,  the  other 
by  his  re-living  them  in  the  form  of  transference.^ 

Let  us  first  consider  remembering.  The  an- 
alysis is  begun  when,  after  the  history  is  taken 
at  the  first  sitting,  the  patient  is  directed  to  talk 
of  whatever  presents  itself  to  his  mind  (to  think 
aloud,  in  short)  relating  whatever  occurs  to  him, 
whether  or  not  it  seems  to  him  important  or 
trivial,  pleasant  or  disagreeable.  Many  patients 
when  started  in  this  way,  will  produce  a  good  deal 
of  valuable  material.  Once  they  have  begun  to 
think  over  their  past  history  and  the   story  of 

iln  the  original  hypnoiie  analyBis  flrat  used  hy  Breaer  and 
Freud  this  taking  of  the  patient  back  to  earlier  experiences 
■eemed  mneh  eimpler  than  it  does  now.  It  was  Buggested  to  the 
patient  that  he  was  In  this  or  that  situation  and  he  was  then 
required  to  desorihe  it  and  his  feelings  in  detalL  Hie  most  un- 
fortunate feature  of  this  otherwise  yery  desirable  method  of 
procedure  Is  that  the  physicisn  does  not  always  know  what 
situations  he  should  make  the  patient  go  back  to,  and  that  to 
flome,  against  which  the  patient  has  strong  resistances  because 
they  are  in  some  way  painf ul,  he  cannot  be  made  to  go  back  in 
i^ite  of  aU  suggesting. 


532    MORBID  FEABS  AND  COMPULSIONS 

the  development  of  their  symptomSi  they  will  not 
only  remember  and  relate  mnch  that  they  had 
known  to  be  important  at  the  time  of  its  ooenr- 
rence,  bnt  also  many  things  the  importance  of 
which  had  previonsly  escaped  them  and  is  now 
recognized  for  the  first  time.  A  good  deal  of  this 
material,  which  we  could  consider  as  belonging  to 
the  nnconscionSy  the  patient  assures  us  he  knew 
all  along.  '^Only  until  now  I  didn't  happen  to 
think  of  it "  The  ^ '  forgetting ' '  of  such  material, 
the  repressing  of  it,  had  consisted  merely  in  its 
being  isolated.^  This  sort  of  forgetting  is  par- 
ticularly common  in  the  compulsion  neurosis.  In 
hysteria  and  anxiety  hysteria  an  absolute  forget- 
ting is  met  with  more  frequently.  There  are  also 
'^ remembered"  certain  internal  psychic  processes 
which  as  a  matter  of  fact  had  never  been  con- 
scious; phantasies,  wishes,  conclusions,  i>ercep- 
tion  of  connections  and  relations  aU  of  which  had 
come  into  being  without  ever  exciting  awareness. 

The  memory  material  thus  collected  gradually 
enables  the  patient  to  view  his  behavior  and  his 
neurosis  (which  is  a  form  of  behavior)  in  a  new 
light  and  from  the  point  of  view  of  its  history. 
He  can  see  more  and  more  what  he  really  is  doing, 
more  and  more  that  he  is  reacting  (is  if  persons 
and  conditions  of  the  past  were  still  present  as 
objects  of  environment.  He  even  passes  a  little 
way  from  the  stage  as  if  I  thought  to  that  of  / 
realise  that  I  have  been  thinking,  unconsciouslif. 

Yet  on  spontaneous  memory  alone  one  can  never 

iCf.  Freud's  Weitert  BdttMiffe,  Int.  Zdt  1  Ant  Fajdba^ 
n»  1914. 


EE-ENACTMENT  533 

rely  for  a  complete  picture  of  a  neurosis.  A 
good  many  gaps  can  be  filled  out  in  this  way,  in 
some  cases.  In  others,  as  early  as  the  first  or  sec- 
ond visit,  the  flow  of  associations  stops  and  the 
patient  declares  nothing  more  occurs  to  him.  But 
in  every  case  memory  sooner  or  later  stops  adding 
to  the  patient's  understanding,  the  associations 
cease  to  flow  freely,  he  no  longer  repeats  with  any 
fidelity  what  comes  to  his  mind*  Instead  of  be- 
coming increasingly  conscious,  by  way  of  the  re- 
production of  associations,  of  what,  in  the  larger 
sense,  he  has  been  doing,  he  now  goes  ahead  and 
does  it.  1  mean  by  this  tliat  he  begins  to  re-enact, 
in  the  transference  to  the  physician,  what  he  has 
been  unable  to  remember.  Old  patterns,  which 
had  previously  found  expression  mainly  in  the 
symptoms,  now  come  more  fully  to  the  surface,  but 
with  the  physician  in  the  role  formerly  occupied 
by  some  other  person.  Naturally  the  transference 
re-enactment  does  not  take  place  entirely  without 
distortion  nor  without  seemingly  logical  connec- 
tion with  the  actual  facts  of  the  immediate  sit- 
nation.  In  other  words  it  appears  to  the  patient 
as  a  product  of  the  present,  not  as  a  relic  of  the 
past.  As  the  two  previously  recorded  cases  did 
not  illustrate  this  very  fully,  I  will  go  on  to 
relate  what  took  place  with  the  male  patient  last 
spoken  of. 

For  a  short  time  after  I  had  given  him  my  ex- 
planation of  his  lack  of  passion  for  his  wife,  he 
added  more  and  more  confirmatory  material  to 
it  and  seemed  more  and  more  satisfied  of  its  cor- 
rectness.   But  though  he  could  plainly  see  that,  as 


534    MORBID  FEABS  AND  COMPULSIONS 

he  himself  expressed  it,  he  was  in  a  measure 
afraid  to  love  his  wife  in  any  other  way  than 
he  had  been  allowed  to  love  his  mother,  yet  he 
complained  that  he  could  remember  very  little  of 
his  early  childhood,  and  of  the  period  where  it 
appeared  that  the  events  responsible  for  the  in- 
tegration of  the  inhibitory  mechanism  took  place. 
He  could  not  recall,  for  instance,  that  he  had  ever 
had  an  interest  other  than  a  ^'pure"  affection  for 
his  mother,  to  say  nothing  of  remembering  any 
occasion  when  he  had  been  scolded  or  punished  for 
'^improper"  interests  in  her.  The  events  which 
constituted  his  repressive  training  were,  in  short, 
completely  lacking  from  his  memory. 

At  length  he  began  to  doubt  very  much  whether 
I  had  explained  his  inhibition  correctly,  saying 
that  if  there  had  occurred  in  his  childhood  train- 
ing any  punishments  or  other  repressive  events 
sufficient  to  have  a  lasting  effect  upon  him,  they 
surely  would  have  made  such  a  deep  impression 
that  he  would  easily  b&  able  to  remember  them. 
But  as  he  was  quite  unable  to  recall  any  such 
occurrences  he  ceased  finally  to  believe  that  any 
inhibition  upon  his  sex  impulses  really  did  exist, 
declaring  that  he  was  now  convinced  that  he  was 
right  in  the  first  place  when  he  thought  that  he 
and  his  wife  were  '*  sexually  mismated"  (L  e. 
that  there  was  no  attraction  to  inhibit  and  that  she 
simply  did  not  appeal  to  him  in  a  physical  way). 
Meanwhile  his  attitude  of  great  interest  in  the 
analysis  and  of  profound  confidence  in  me  changed 
into  one  of  a  sulky  antagonism.  Instead  of  being 
as  at  first  perhaps  over  credulous  he  was  now 


TBANSFERENCE  RESISTANCE     535 

always  on  the  defensive  and  ready  to  pick  flaws  in 
anything  I  might  say,  even  though  this  was  gen- 
erally done  in  a  somewhat  hesitant  manner,  as  if 
he  were  a  little  afraid  of  me. 

After  a  considerable  time  the  set  of  facts  which 
explained  this  change  was  forthcoming.  They 
belonged  mider  two  headings.  In  the  first  place 
there  was  a  matter  he  was  not  telling  me.  Across 
the  court  in  the  apartment  house  where  he  lived 
were  the  rooms  of  a  young  woman.  It  was  in  the 
summer  and  he  had  discovered  that  she  very  often 
neglected  to  pull  down  the  shades  when  she  was 
undressing  for  bed.  He  had  fallen  into  a  habit 
of  watching  her.  Apparently  she  was  an  actress, 
for  she  usually  came  in  quite  late  in  the  evening, 
after  he  and  his  wife  had  gone  to  bed.  He  would 
tell  his  wife  that  he  could  not  sleep,  and,  getting 
up,  would  go  to  the  living  room  of  his  apartment, 
from  which  this  girl's  bedroom  was  plainly  vis- 
ible if  her  shades  were  up,  and,  sitting  there  in  the 
dark,  would  watch  her  while  she  was  disrobing. 
This  would  get  him  into  a  state  of  great  sexual 
excitement  and  sometimes  he  would  return  to  his 
bedroom  and  have  intercourse  with  his  wife, 
meanwhile  imagining  she  were  this  girl,  which 
added  considerably  to  the  pleasure  he  was  ac- 
customed to  gain  from  his  sexual  relations. 

He  had  not  felt  particularly  troubled  about 
what  he  was  doing  until  one  evening  when  he  was 
watdiing  the  young  woman  there  came  upon  him 
the  thought:  "What  a  contemptible  picture  you 
make — ^you,  a  married  man — sitting  here  in  the 
dark,  peeping  at  this  girl,  like  a  nasty  minded  lit- 


536    MORBID  FEARS  AND  COMPULSIONS 

tie  boy  I  Suppose  70a  told  this  to  the  doctor! 
He  would  give  you  hell  I  He  might  refuse  to  treat 
you  if  you  did  not  stop  it  at  once  I" 

But  these  feelings  of  mortification  and  self-re- 
proach soon  became  mixed  with  a  sense  of  resent- 
ment against  me.  ^'Why  should  I  tell  him  about 
itr'  the  patient  had  thought,  ^^  What  business  is  it 
of  hist  Am  I  not  a  man  and  can  I  not  do  as  I 
please,  without  running  to  him  and  confessing  t" 
And  then  at  other  times  he  would  think:  '^Why 
should  I  be  afraid  to  tell  himf  Suppose  he  does 
criticize  me,  he  is  not  God.  Why  shoxdd  I  caret 
He  is  no  better  than  L  Very  likely  he'd  do  the 
same  thing  if  he  got  the  chance  I" 

While  this  conflict  was  going  on,  a  second  arose. 
As  he  was  sitting  one  day  in  my  waiting  room,  he 
heard  me  laughing  with  the  patient  who  preceded 
him  and  who  was  just  leaving.  As  she  passed  the 
waiting  room  door,  he  saw  that  she  was  a  good- 
looking  young  woman.  '^  Aha !"  he  thought,  ^Hhe 
doctor  is  very  friendly  with  his  lady  patients  1 
I'll  bet  there's  something  doing!"  From  that 
time  on  he  was  continually  on  the  alert  to  find 
out  something  about  me.  If  I  was  called  on  the 
telephone  when  he  was  in  my  office,  he  would 
listen  to  see  whether  he  could  figure  out  from  the 
conversation  whether  the  other  person  was  a 
woman  and  whether  there  was  anything  '^inti- 
mate" between  us. 

If  I  ever  left  the  room  when  he  was  in  my  office, 
he  would  be  assailed  by  a  great  curiosity  to  look 
at  the  letters  and  papers  lying  on  my  desk,  and 
this  temptation  on  one  or  two  occasions  he  was 


TEANSPEBENCE  BESISTANOB     837 

unable  to  resist.  On  the  street  one  evening  he 
saw  at  some  distance  in  front  of  him  a  man  he  took 
to  be  me,  walking  with  a  woman.  He  wondered 
whether  this  was  my  wife  with  me  or  whether  I 
was  out  for  a  ** party''  with  one  of  my  patients. 
Overcome  with  cariosity  to  see  whom  I  was  with 
and  where  I  was  going,  he  hastily  followed,  keep- 
ing in  the  shadows  of  the  buildings  in  order  to 
escape  observation  himself,  only  to  discover  after 
he  had  gone  some  distance  that  the  couple  he  had 
been  watching  were  really  perfect  strangers. 

He  became  consumed  with  curiosity  about  my 
private  life.  What  sort  of  person  was  my  wifet 
How  did  I  get  along  with  hert  What  were  our 
sexual  relations?  Did  I  have  affairs  with  other 
women?  He  had  an  impulse  to  picture  to  him- 
self in  phantasy  intimate  scenes  of  my  home,  feel- 
ing at  the  same  time  a  certain  envy,  as  if  in  some 
mysterious  way  evergrthing  sexual  in  my  existence 
must  be  somehow  superior  to  and  different  from 
anything  he  could  experience,  and  that  I  had  un- 
known pleasures  which  would  be  forever  denied 
to  him.  Sometimes  he  felt  hurt  that  I  did  not  take 
him  into  my  confidence  and  tell  him  all  about  these 
intimate  things.  I  must,  he  thought,  know  a 
good  deal  about  sex  that  he  did  not,  and  why  had 
I  to  be  so  reserved?  Why  couldn't  I  tell  him 
frankly  of  my  own  feelings  and  experiences  and 
let  him  improve  his  relations  with  his  wife  by 
copying  me  instead  of  through  the  disagreeable 
and  lengthy  process  of  analysis? 

All  this  took  place  with  the  greatest  conflict. 
He  felt  himself  utterly  mean,  dishonorable  and 


538    MORBID  FEABS  AND  COMPULSIONS 

contemptible  to  be  so  continually  suspicious  of  me 
and  to  have  such  an  irresistible  curiosity  about  my 
private  affairs.  That  he  had  looked  at  my  letters 
or  been  willing  to  spy  upon  me  on  the  street 
seemed  to  him  the  lowest  limit  of  sneaking  eon- 
temptibility.  But  what  is  more  to  the  point  is 
that  he  was  mortally  afraid  of  my  anger  if  I 
found  out  what  he  had  done.  '  ^  How  can  y ou, ' '  he 
thought,  *^  confess  to  the  doctor  how  nosey  you 
have  been?  He  would  never  forgive  you  I  He 
never  talks  of  his  own  affairs,  and  that  should 
have  warned  you  how  he  would  resent  any  one's 
prying  into  them  I  What  would  he  think  if  he 
knew  you  had  tried  to  picture  his  sexual  rela- 
tions with  his  wife ;  that  you  had  tried  to  imagine 
how  she  would  look  undressed;  that  your  foul 
mind  had  attempted  to  invade  every  nook  and 
comer  of  his  privacy;  that  you  had  suspected 
him  of  immorality  with  his  women  patients  1 
Suppose  he  were  to  discover  some  of  these  things 
from  one  of  your  dreams.  He  would  be  furi- 
ous I" 

He  not  only  feared  my  anger  as  such  but  also 
what  I  would  do  if  I  were  angry.  "This  man," 
he  thought,  "has  no  inhibitions  or  fears.  In  his 
anger  he  would  be  absolutely  merciless.  There 
is  no  telling  what  he  ntdght  do  to  you.  He  could 
cause  a  lot  of  harm  if  he  told  what  he  knows 
about  you,  and  he  might  not  hesitate  to  do  it 
Doubtless  he  has  powerful  friends  among  busi- 
ness men,  and  in  his  desire  for  revenge,  he  would 
enlist  their  help  and  ruin  you,  or  he  might  do  you 
some  physical  injury.''    These  and  other  fears  of 


TRANSFERENCE  RESISTANCE     539 

my  vengeance  (some  of  them  quite  fantastic), 
assailed  and  tormented  the  patient  unspeakably. 
In  spite  of  the  great  absurdity  of  most  of  them 
they  were  entirely  real  to  him. 

The  material  which  I  have  here  recited,  with 
more  of  a  similar  tenor,  was  brought  out  slowly 
and  f ragmentarily,  with  every  sign  of  the  great- 
est resistance  on  the  part  of  the  patient.  It 
seemed  hardly  to  have  occurred  to  him  that  there 
was  any  possibility  of  my  not  resenting  his  **  pry- 
ing'' or  of  my  failing. to  take  action  against  him 
once  I  discovered  it.  And  when  he  had,  after 
great  difficulty,  told  me  one  item,  the  fact  that  I 
took  it  quite  indifferently  seemed  to  give  him  no 
assurance  that,  when  he  had  come  to  the  next  one, 
I  would  not  resent  that.  At  such  times  as  he  was 
about  to  tell  me  some  one  of  these  things,  he 
would  squirm  about  in  his  chair  with  every  sign 
of  the  greatest  uneasiness  and  apprehension.  In- 
variably he  would  raise  his  hand  to  his  face  and 
turn  his  head  from  me  at  the  moment  of  making 
the  "confession."  This,  when  I  first  called  his 
attention  to  it,  he  said  was  because  of  mortifica- 
tion. He  could  not  bear  to  look  at  me  when  he 
was  relating  things  about  himself  which  showed 
him  to  be  such  a  "dishonorable  sneak."  Yet  at 
length  it  dawned  upon  him  that  the  real  purpose 
of  the  gesture  was  to  ward  of  an  tmconsciously 
expected  blow. 

It  was  only  when  this  realization  came  to  him 
that  he  began  to  see  what  was  really  meant  by  his 
feelings  of  guilt  before  me  and  his  fears  of  my 
anger-— namely  that  all  these  manifestations  were 


540    MOBBID  FEABS  AND  COMPULSIONS 

transf erenoe  phenomena  and  reproductions  of  the 
long-forgotten  past.  What  he  had  experienced 
with  me  was  really  a  living  over  again  of  nnre- 
membered  incidents  of  his  childhood,  subject  to 
enough  distortion  and  rationalization  to  accord 
them  with  the  present.  The  important  episodes 
of  his  early  corrective  training  which  he  had  been 
unable  to  remember,  he  had  reenacted  with  me. 
The  inquisitiveness,  the  spying  and  the  suspicions 
he  had  expected  I  would  resent  and  avenge,  cor- 
responded to  the  infantile  sexual  curiosity  that 
had  been  active  in  his  childhood.  His  sense  of 
guilt  and  his  fear  of  me  were  a  reproduction  of 
what  he  had  originally  felt,  on  much  more  logical 
grounds,  in  connection  with  his  father. 

At  last  when  he  understood  what  all  this  really 
meant,  there  came  the  direct  recollections  of  ac- 
tual experiences,  which  had  previously  eluded  us. 
When  he  was  about  five  years  of  age,  or  perhaps 
even  younger,  he  had  been  playing  in  a  neighbor's 
garden  with  a  little  girl  of  seven.  She  had  volun- 
teered to  show  him  ''what  papa  and  mama  did," 
and  after  unbuttoning  her  clothing,  and  assisting 
him  to  do  the  same,  they  displayed  to  one  an- 
other their  buttocks  and  genitals,  and  urinated  in 
each  other's  presence.  She  told  him  that  all  mar- 
ried people  diid  this  in  their  bedrooms  every  night 
In  the  midst  of  the  proceedings  the  little  girPs 
mother  spied  them  from  the  window,  and,  sending 
her  daughter  into  the  house,  took  the  little  boy 
home  and  told  his  mother  what  had  been  going  on. 
Both  children  were  severely  punished  and  not  al- 
lowed to  play  together  again.    In  the  transfer- 


ANALYSIS  OF  TRANSFERENCE    541 

ence,  the  spying  on  the  yonng  actress,  about  which 
the  patient  feared  to  tell  me  and  over  which  he 
felt  so  very  guilty,  apparently  corresponded  to 
this  episode.  He  unconsciously  expected  that  I 
would  take  much  the  same  attitude  with  regard 
to  this  adult  experience  that  his  parents  had  taken 
toward  the  earlier  one. 

Some  little  time  later,  shortly  after  his  experi- 
ence with  the  little  girl  and  before  the  patient  was 
six,  he  had  hidden  under  the  bed  in  his  mother's 
room,  hoping  to  see  her  use  the  chamber  vessel 
What  the  little  girl  had  told  him  and  what  he  had 
seen  of  her  genitals  had  greatly  excited  his  curios- 
ity and  at  the  same  time  puzzled  and  disturbed 
him.  Why  had  she  no  projecting  organ  like  his 
ownf  Was  his  mother  that  way  toof  And  did 
married  people  really  do  at  night  what  the  little 
girl  said  they  didf  If  so,  why  was  it  he  had  been 
so  severely  punished?  He  felt  he  must  find  out, 
and  therefore  embarked  on  the  adventure  in  his 
mother's  bedroom.  But  she  discovered  him  in 
his  hiding  place,  and  seemed  to  divine  at  once 
what  was  his  purpose  in  being  there.  She  ques- 
tioned him  closely  but  he  desperately  maintained 
that  he  was  merely  'Splaying,"  and  begged  her  not 
to  tell  his  father  as  she  had  threatened  to  do. 
She  seemed  not  to  be  fully  convinced  of  his  in- 
nocence but  finally  said  she  would  not  tell  if  he 
would  promise  to  be  a  good  boy. 

After  this,  what  attempts  he  made  to  gratify  his 
sexual  curiosity  were  carried  on  in  the  most  crafty 
manner,  and,  though  he  did  not  at  once  abandon 
his  investigations  but  for  a  time  continued  on  the 


542    MORBID  FEARS  AND  COMPULSIONS 

alert  to  find  oat  anything  possible  as  to  what  went 
on  between  his  parents,  this  was  all  done  with 
such  an  appearance  of  artless  innocence  that  they 
were  completely  deceived.  Never  did  he  really 
satisfy  himself  as  to  what  did  take  place  between 
them  and  at  length  the  somewhat  deferred  latency 
period  set  in,  and  the  whole  history  of  this  period 
of  investigation  was  almost  completely  lost  to  his 
consdons  memory,  so  that  when  he  was  later  told 
abont  interconrse,  he  was  snre  his  mother  would 
not  do  such  a  ''dirty  thing.''  It  is  easy  to  see, 
however,  that  his  transference  cariosity  aboat  my 
sexaal  life,  his  desire  to  have  me  describe  to  him 
my  own  feelings  and  experiences,  his  thoughts 
about  my  wife  (whom  he  had  never  even  seen), 
his  uncertainty  as  to  my  morality,  etc.,  coincided 
with  the  early  inquisitiveness  and  uncertainty 
about  his  parents,  while  his  antagonism  toward 
me  and  his  ideas  about  how,  in  my  anger,  I  would 
take  revenge  on  him,  were  descendants  of  the 
early  and  well-founded  fear  of  punishment  from 
his  father. 

With  the  filling  out  of  memory  gaps  that  came 
from  the  transference  itself  and  from  the  addi- 
tional memory  reproductions  which  occurred  after 
the  transference  had  ceased  to  act  as  a  resistance, 
the  patient  became  at  last  not  only  fully  con- 
vinced that  his  lack  of  contentment  with  his  wife 
was  due  to  the  functioning  of  a  compound  habit 
which  exerted  an  inhibition  upon  the  more  sen- 
sual components  of  the  love  life,  but  he  could  now 
see  the  constituents  of  this  habit,  its  unconscious 


ANALYSIS  OP  INHIBITION         543 

factors,  and  the  why  of  its  continaed  operation. 
It  became  dear  to  him  that  an  important  constit- 
uent of  this  habit  or  inhibition  was  an  uncon- 
scious ^  f ear,  on  the  one  hand,  of  punishment  from 
the  f ather,  and,  on  the  other,  of  exciting  the  dis- 
approval of  the  mother  (his  wife) — ^that  he  was 
reacting  as  if  the  original  conditions,  which 
through  exciting  such  fears  had  served  to  sup- 
press his  sex  impulses  in  childhood,  were  still 
present  and  still  to  be  feared.  With  this  vision  of 
what  he  really  was  doing  came  the  freedom  to 
make  new  and  more  satisfactory  adaptations. 

As  must  now  be  clear,  the  curiosity  or  looking 
impulse  was  strongly  developed  in  this  patient. 
But  it  had  been  very  much  inhibited  in  his  rela- 
tions with  his  wife.  For  instance,  if  he  came  into 
the  room  when  his  wife  was  partially  dressed,  he 
would  quite  automatically  look  away  from  her  or 
act  as  if  he  had  not  noticed  that  she  was  not  fully 
clothed.  What  exposure  of  her  person  took  place 
with  the  performance  of  their  sexual  relations  he 
seemed  almost  to  ignore.  Though  previously  he 
had  not  recognized  this,  he  at  length  saw  that 
whatever  gratification  of  his  looking  impulse  he 
had  allowed  himself  in  his  relations  with  his  wife 
was  accomplished  in  a  furtive  manner  and  in  such 
a  way  as  to  conceal  from  her  the  fact  that  he  had 
any  desire  to  look.  He  behaved  with  her,  in  short, 
just  as  if  she  would  react,  should  she  catch  him 
looking  at  her,  as  his  mother  would  have  reacted. 
Unconsciously  he  expected  she  would  scold  him 

1  strictly  speaking,  f oreoonadouB. 


544    MOEBID  FEARS  AND  COMPULSIONS 

or  give  him  over  to  punishment.  But  this  inhibi- 
tion had  functioned  so  subtilely  that  he  had  not 
realized  what  was  taking  place. 

Instead  of  being  aware*  that  really  he  had  a 
strong  desire  to  look  at  his  wife's  person,  and 
oould  derive  great  pleasure  from  doing  so  were  it 
not  for  an  inhibition,  he  felt  that  she  did  not  in- 
terest him  physically,  that  her  bodily  charms  were 
not  of  the  special  sort  that  could  appeal  to  him. 
In  short,  he  could  freely  gratify  his  looking  im- 
pulse only  in  phantasies  of  sexual  scenes  with 
other  women,  or,  as  in  his  premarital  experi- 
ences, when  his  inhibition  was  overcome  by  the 
woman's  making  manifest  that  she  was  not  over- 
burdened with  modesty,  and  that,  like  the  *^bad" 
little  girl  in  his  childhood,  she  would  take  pleasure 
in  being  looked  at,  instead  of  resenting  it.  The 
fact  that  in  his  unconscious  the  looking  desire  in- 
cluded a  wish  to  witness  the  excretory  process  of 
the  female,  in  short,  to  repeat  what,  as  a  child,  he 
had  experienced  with  the  neighbor's  litUe  girl, 
of  course  made  the  inhibition  upon  the  looking  im- 
pulse even  more  difficult  for  him  to  overcome  than 
might  otherwise  have  been  the  case. 

What  I  have  related  of  the  analysis  of  the 
inhibiting  habits  that  functionated  in  the  patient's 
love  life  is  of  course  only  a  part  of  the  whole 
story,  but  the  rest  is  not  required  for  our  purposes 
here.  The  inhibition  on  the  looking  impulse  was 
completely  paralleled  in  respect  to  others  of  the 
patient's  sensuously  erotic  tendencies.  As  the 
analysis  drew  to  a  close  he  was  able  to  see  dearly 


ANALYSIS  OF  INHIBITION         545 

that,  as  he  had  at  first  surmised,  the  doubts,  re- 
siBtances  and  inhibitions  that  he  met  with  in  his 
business  life  were  merely  a  diffusion  or  displace- 
ment of  affects  that  really  had  their  immediate 
origin  in  his  life  at  home — for  instance,  his  fear  of 
making  a  mistake  that  would  have  most  serious 
consequences  was  really  a  descendant  of  the  old 
fear  of  being  punished  by  his  father  for  the  ex- 
pression of  (now  repressed)  sexual  interests.  It 
need  hardly  be  said  that,  once  the  interfering  in- 
hibitions were  broken  up,  the  patient  was  enabled 
thoroughly  to  content  himself  with  his  wife,  while 
the  phantasies  about  other  women  and  his  desire 
to  be  free  to  pursue  them  disappeared  entirely. 

The  integrations  which  functioned  in  his  rela- 
tions with  me  had  been  set  in  motion  by  many 
other  sorts  of  stimuli  and  in  many  other  contacts 
in  his  life.  But  outside  of  the  analysis,  however, 
the  system  of  habits,  the  complex,  had  worked  for 
the  most  part  from  beneath  the  surface,  so  to 
speak.  Even  when  its  influence  was  profound, 
only  a  small  part  of  the  entity  appeared  in  con- 
sciousness, and  even  this  was  rationalized  into 
accord  with  the  immediate  situation.  !bi  the 
analysis,  however,  as  the  constellation  was  stimu- 
lated and  rose  to  the  surface,  it  was  caught  and 
held.  Instead  of  being  permitted,  as  ordinarily, 
again  to  recede  to  unconscious  levels,  it  was  hauled 
out  further  and  further,  and  at  last  delivered  in 
its  entirety  from  the  depths  of  the  non-perceiv- 
able and  surrendered  to  examination  into  its  every 
part.    Then  and  only  then  was  it  deprived  of 


546    MORBID  FEABS  AND  COMPULSIONS 

antonomoasnesB  and  independence  of  action  and 
rendered  assimilable  with  the  resnlts  of  adult  ex- 
perience and  the  requirements  of  adnlt  life. 

The  breaking  up  of  the  pathological  integra- 
tions which  function  either  as  repression  resist- 
ances or  as  fixations  of  instinctive  tendencies  is 
accomplished,  as  has  now  been  illustrated,  by  mak- 
ing the  patient  live  over  again  the  experiences 
which  were  instrumental  in  forming  the  intgera- 
tions.  These  experiences  he  may  re-live  either  in 
memory,  which  he  does  not  confuse  with  the  pres- 
ent, or  in  the  form  of  transference,  which  he  feels 
arises  from  the  present.  By  this  re-living  of  the 
past  he  can  see  what  he  is  really  doing  in  the 
present,  namely,  that  he  is  reacting  as  if  much 
of  the  past  were  still  in  existance.  We  have  said 
that  when  he  knows  what  he  is  really  doing  he  is 
then  free  to  do  otherwise  if  adaptation  demands 
it  But  I  must  now  state  that  this  knowing  has 
to  be  of  a  very  special  sort.  It  must  be  a  know- 
ing that  comes  from  re-living ,  either  in  memory, 
or  in  transference.  A  mere  intellectual  knowl- 
edge of  the  significance  of  a  habit,  a  resistance 
or  a  symptom  ordinarily  does  not  break  up  the 
integration,  or  prevent  it  from  continuing  to  func- 
tionate. In  this  particular  case,  for  example,  I 
was  able  to  divine  quite  completely  from  dreams, 
symptoms,  and  associations,  what  sorts  of  occur- 
rences had  taken  place  in  the  patient's  childhood 
to  create  the  repression  resistances  that  were  func- 
tioning. I  told  him  a  good  part  of  what  I  had 
discovered,  and  for  a  time  at  least  he  agreed  that 
in  all  probability  I  was  correct.    But  this  did 


ANALYTIC  UNDBSTANDING       647 

not  have  either  the  effect  of  bringing  to  his  con- 
sdousness  the  actual  recollections  of  the  incidents 
in  question,  nor  of  producing  any  amelioration  of 
the  symptoms.  When  the  physician  gives  to  a 
patient  a  perfectly  correct  explanation  of  the  un- 
conscious ideas  or  wishes  which  are  responsible 
for  a  symptom  or  resistance,  he  merely  introduces 
into  the  patient's  consciousness  new  ideas  having 
the  same  content  as  the  unconscious  ones.  This 
is  not  the  same  as  bringing  the  unconscious  ideas 
into  consciousness,  and  the  explanation  has'  no 
great  effect  upon  the  symptom  unless  it  serves  (as 
it  may  do)  to  bring  up  this  missing  material  from 
the  unconscious. 

This  shows  that  the  explanation  that  has  been 
here  given  of  the  effect  of  psychoanalysis  does  not 
explain  very  extensively.  Certainly  it  is  not  any 
ordinary  kind  of  ** knowing''  or  '^understanding" 
that  cures  the  patient.  It  is  a  living-over-again 
of  that  which  had  subsided  from  consciousness 
that  has  the  therapeutic  effect,  but  just  what  this 
really  consists  in,  or  why  it  should  have  just  this 
effect,  is,  to  my  mind  at  least,  decidedly  obscure. 
Obviously,  an  important  fact  is  that  the  patient 
is  released  from  depending  on  ready-made  and 
outworn  responses  to  meet  present  situations,  and 
gains  thereby  an  enormous  freedom  to  make  new 
adaptative  reactions — he  becomes  flexible,  while 
before  he  was  crystallized — ^but  exactly  what  takes 
place  inside  of  him  we  can  express  only  in  terms 
of  ideas.  What  changes  are  made  in  the  integra- 
tion of  reflex  paths,  and  exactly  how  they  come 
to  be  made,  we  can  hardly  even  guess. 


548    MOBBID  FEABS  AND  COMPULSIONS 

It  is  dear,  however,  that  psychoanalysis  is  a  re- 
education,  in  the  very  fullest  sense.  As  Burrow 
has  remarked,  education,  as  it  is  ordinarily  car- 
ried on,  really  belies  its  name.  The  word  im- 
plies a  leading  out ;  the  process  is  largely  a  press- 
ing in.  Familial,  and  to  a  less  extent,  school  train- 
ing have  not  been  predominantly  devoted  to  dis- 
covering what  were  the  special  tendencies  with 
which  instinct  had  endowed  each  individual,  and 
to  leading  out  these  energies  along  the  lines  that 
would  give  them  fullest  and  most  advantageous 
expression.  The  training  most  children  receive, 
in  the  home  especially,  has  generally  been  some- 
what in  imitation  of  the  mythological  Procrustes 
who  had  a  bed  in  which  he  would  invite  traveler 
to  sleep.  If  the  guest  were  too  short  for  the  bed, 
the  host  would  stretch  him  until  he  was  long 
enough  to  fill  it ;  if  he  were  too  long  for  the  bed, 
enough  of  his  person  would  be  chopped  off  to 
make  him  fit  it  perfectly.  Education  has  shown 
similar  tendencies.  There  has  been  a  disposi- 
tion to  fit  the  child  to  the  training,  rather  than 
to  fit  the  training  to  the  child.  This  has  been 
espedally  true  in  regard  to  the  developing  sex  im- 
pulses. Scoldings,  punishments,  and  other  re- 
pressive measures  are  applied  with  the  greatest 
energy  toward  making  the  sexuality  of  the  grow- 
ing individual  conform  to  fixed  and  predetermined 
standards  of  what  should  be,  and  which,  inci- 
dentally, are  in  many  instances  founded  more 
largely  upon  prejudice,  superstition  and  igno- 
rance, than  upon  any  accurate  knowledge  of  sexual 
psychology  and  physiology,  or  upon  sympathetic 


ANALYTIC  BE-EDUCATION         549 

oommon  sense.^  Where  familial  influence  and 
training  have  established  habits  which  inhibit  nor- 
mal sexual  tendencies  from  expressing  themselves, 
or  which  maintain  fixations  of  others  that,  for  the 
adulty  are  really  abnormal,  psychoanalysis  per- 
forms a  truly  educative  function.  The  pathogenic 
habits,  inhibitions,  or  resistances  are  overcome 
and  the  individual's  instinctive  energies  led  out  to 
express  themselves  in  the  fullest  measure  possible, 
either  in  the  form  of  normal  love  activities  or  by 
way  of  sublimation. 

It  is  evident  in  the  case  of  the  patient  we  have 
just  considered  that  the  habits  established  by  the 
moral  training  received  in  childhood,  the  purpose 
of  which  was  to  withhold  him  from  immoral  ac- 
tion when  he  grew  up,  formed  the  very  factor 
which  interfered  with  his  making  a  moral  adapta- 
tion and  bid  fair  to  drive  him  into  immorality  (in- 

1  It  is  very  commonly  true  that  parents,  in  bringing  up  their 
children,  do  not  utilize  much  of  the  knowledge  and  good  sense 
they  really  possess,  but  instead  fall  into  an  unconscious  identi- 
fication with,  and  consequent  imitation  of,  their  own  parents. 
Thus  they  not  only  reproduce  with  their'  own  children  practically 
all  the  mistakes  of  their  own  bringing  up,  but  fail  to  take  ad- 
vantage of  what  opportunities  for  advance  are  offered  to  the 
newer  generation. 

The  fidelity  of  such  unconscious  imitations  is  not  only  in  many 
cases  most  striking  but  at  times  reaches  the  point  of  the  ludi- 
crous. I  am  acquainted  with  a  man  who,  not  entirely  without 
reason,  considers  his  father  an  utter  fool,  whose  opinion  on  any 
subject  under  the  sun  could  by  no  chance  be  correct  or  worth  a 
moment's  consideration.  Nevertheless  this  man.  In  training  his 
own  son,  imconsciously  reproduces,  with  absolute  fidelity,  the 
training  his  despised  father  gave  him. 

The  psychology  of  parenthood,  as  well  as  the  psychology  of 
childhood  might  be  studied  with  profit  by  those  who  are  working 
for  educational  advance. 


550    MORBID  FEAES  AND  COMPULSIONS 

fidelity  to  his  wife)  in  the  search  for  a  field  in 
which  his  sex  impulses  could  secure  free  outlet 
That  which  saved  the  patient  from  this  danger  and 
made  it  easy  for  him  to  be  content  with  a  i>er- 
f ectly  moral  marital  life  was  really  the  overcom- 
ing of  certain  moral  impulses.  In  other  words, 
as  this  case  exemplifies,  the  resistances  which  are 
dissolved  in  the  analysis  are  in  part  moral  re- 
sistances, habits  which  have  been  instilled  by  eth- 
ical training. 

If  psychoanalysis  dissolves  certain  moral  in- 
hibitions the  effect,  one  would  think,  must  be  to 
make  it  easier  for  the  individual  to  be  immoral 
In  a  measure  this  is  true.    But  on  the  other  hand, 
as  in  the  case  we  have  considered,  the  effect  is  like- 
wise that  of  making  it  easier  for  the  individual  to 
be  moral,  and  to  feel  content  in  so  being,  while 
according  to  all  experience  the  moral  course  is 
that  which  after  the  analysis  he  ordinarily  pur- 
sues.   Thus   the   result   of   overcoming   certain 
moral  inhibitions  may  really  be  the  attainment  of 
a  higher  degree  of  morality  than  was  possible 
while  they  were  in  force.    Nowjreally  the  pnr- 
I20S6. of  .psychoanalysis  is  practically  identical  wiOi 
that  of  moral  instruction  and  moral  codes  (if 
viewed -according.,TQ~Jtheir  Jbasic  significance), 
joameLy,  the  highest  welf are_of  the  individual  as 
a  member.of  the  social  group,  the  best  possible 
adaptation-of  hiTnflftlf  f  q  ^ir  ftTyyirnnniftTif     If  psy- 
choanalysis led  to  a  real  immorality,  it  would  de- 
feat its  own  purpose.    Its  prime  role  really  is  to 
step  in  and  do  for  the  individual  what  the  ordi- 
nary moral  forces  had  tried  to  do  for  him  bat 


ANALYTIC  RE-EDUCATION        561 

failed.  The  analysis  does  not  seek  to  overcome 
morality  bnt  rather  certain  moral  inhibitions  or 
habits  which  have  ontlived  their  nsefnlness,  and 
defeat  their  proper  purpose  by  interfering  with, 
rather  than  furthering,  the  welfare  of  the  individ- 
ual and  his  adaptation  to  life.  It  assists  him  to 
abandon  these  old  moral  inhibitions  in  favor  of 
newer  controlling  and  adaptive  machinery  more 
efficient  than  the  old.  It  tries  to  perfect,  to  im- 
prove upon,  that  intricate  system  of  '^habits  not 
only  of  acting,  but  of  feeling  and  believing  about 
actions,  of  valuing  or  approving  and  disapprov- 
ing"^ which  the  individual  calls  his  conscience 
and  which  has  as  some  of  its  basic  constituents 
certain  pathological  resistances  and  inhibitions 
which  result  from  ignorant,  if  well  intended,  par- 
ental efforts  to  shape  the  child's  personality  ac- 
cording to  standards  that  take  no  account  of  the 
natural. 

Sexuality,  even  perfectly  normal  sexuality, 
gives  rise  to  most  serious  and  difficult  adaptive 
problems,  and  may  easily  be  the  spring  of  actions 
which  will  end  in  pain  or  misery  or  disaster  for 
the  individual  But  for  this  very  reason,  and 
quite  apart  from  the  question  of  making  the  most 
of  the  instinct's  great  potentialities  for  happiness 
and  for  good,  all  efforts  toward  establishing  hab- 
its that  shall  control  and  direct  the  erotic  ener- 
gies need  to  be  xmdertaken  in  the  most  carefully 
considered  and  enlightened  manner  that  is  hu- 
manly possible.  Man's  effort  to  overcome  the  im- 
perious domination  of  sexuality  has  been  at- 

1  Dew^  and  Tiift8»  SiMeB,  p.  178. 


552    MOBBID  FEABS  AND  OaMFOLSIONS 


tempted,  as  HmUe  remarks,  ^^hy  lowering  the  iit* 
stinct,  and  seeing  in  it  something  Tile  or  mr- 
dean,  something  unspeakable  and  nnholy.    In- 
stead of  destroying  the  power  of  sexnaHty  this 
stmggie  has  only  warped  and  distorted,  injured 
and  mutilated  tiie  expression;  for  not  without 
destruetiou  of  the  individual  can  these  fundamen- 
tal  instinots  be  destroyed.    life  itself  has  needs 
and  imperiously  demands  ei^ression  throikgh  the 
f onmi  created.    AH  nature  answers  to  this  freely 
and  simply  except  man.    His  failure  to  recognize 
himself  as  an  instmmei;!  through  which  life  is 
coursing  and  the  demandi  of  whidb  must  be 
obeyed,  is  the  cause  of  his  misery—"  ^    Ignorant 
and  too  rigorous  early  r^ressive  trmning,  bad 
family  inSuenoes^  or  unaataral  ideals  establish  in 
the  diild  such  habits  ''of  feeling  and  believing 
aBout  aetiens"  that  when  he  becomes  an  adult 
he  can  not  without  pain  and  horror  see  hiTuaetf  as 
lie  actually  is.    Tendencies  wfaadk  are  imiate  and 
inevitaUe  become  sources  for  the  develoimient  of 
tormenting  affects  of  guilt;  eneri^es  that  are 
normal  and  deserving  of  direct  expression,  and  en- 
ergies that,  though  not  normal,  could  become  so, 
are  fruitlessly  and  wastefully  confined  and  re- 
pressed.   Instead  of  securing  outlet  in  the  form  of 
activities  that  are  compatible  with  the  require- 
ments of  Bodal  existence,  and  which  could  be  given 
them  once  they  were  faced  and  understood,  many 
of  these  fundamentally  normal  and  natural  im- 
pulses remain  as  skeletons  in  the  closets  of  the 

iB.  M.  Hinkle,  Ifttroduceiaii  to  Jvb^b  Pifokolofff  of  ^  Vth 
h  P'  zlii. 


ANALYTIC  RE-EDUCATION        553 

individnal's  psychic  household,  which  whenever 
he  gets  a  glimpse  of  ihem,  excite  him  to  spasms 
of  morbid  fear.  The  overcoming  of  resistances 
which  occurs  with  analysis  reeducates  him  to  new 
points  of  view.  It  enables  to  see  the  whole  of 
himself  as  it  actually  is;  to  face  his  defects, 
whatever  they  may  be,  without  horror  or  self  re- 
proach, but  simply  as  matters  of  biological  fact; 
and  to  develop  the  energies  at  his  disposal  along 
the  lines  that  will  most  fully  adapt  him  to  his 
place  in  life.  This  is  accomplished  not  so  much 
hy  teaching  him  new  standards  as  by  unteaching 
old,  erroneous  and  distorted  ones. 


CHAPTEBI  ^ 

EUifly  H«— AutoerotiBm ;  AnalyBis  of  the  Sexual  Ln- 
pnlae;  Love  and  Pain;  Erotic  Symbolism;  Sezoal 
Invexsion,  in  the  Studies  in  ike  Fsycholagy  of  Sex,  ^ 

F.  A.  Dayia  C!o. 

Fread,  &— Three  Contributiona  to  the  Sexoal  The- 
ory, 2d  Edition,  translated  by  A.  A.  Brill,  The 
Jawmal  of  Nervoue  and  Mental  Dieeaee  Monograph 
Series,  No.  7. 

Triebe  nnd  Triebahicksale,  Ifiternatiandle  Zeit-^ 
sehrift  fur  SrztUche  Psychoanaiyse,  YoL  III.,  1915. 
Beitrage  zor  Pqrchologie  des  Liebeslebena  IL, 
Jakrhuch  fur  psyckoanalyiische  und  psyehopathr' 
ohgisehe  Forsehungen,  Bd.  IV.,  Hit  I.,  1912. 
TTeber  Infantile  Sexoaltheorien,  Sammlung  hteiner 
Sekriften  zur  Neurosenlekre,  Bd.  n.,  S.  Ej^ger, 
Berlin. 

The  Origin  and  Development  of  Psychoanalysis, 
American  Journal  of  Psychology,  Vol.  XXI.,  No. 
2, 1910. 

Analyse  der  Phobic  einea  fflniQahrigen  Ejiaben, 
Jakrhueh  fUr  Psychoanal^istihe  und  PsyehopathoU 
ogische  Forsehungen,  Bd.  I,  Hft  1, 1909. 

'Frink,  H.  W.— The  Sezoal  Theories  Formed  in  Early 
Childhood,  and  Their  Bdle  in  the  Psyehonenroses, 
New  York  Medical  Journal,  November  15, 1915. 

Hng-Hellmnth,  H.  von. — ^Aus  den  Seelenleben  des 
Ejndes,  F.  Deaticke,  "Vienna. 

Jones,  B. — ^Die  Empfangnis  der  Jnngfran  Maria  dnreh 


556  BIBLIOGBAPHT 

das   Ohr,   Jdkrbuck   der  Ptyehoandlyse,   Bd.    6^ 

1914. 
Jang,  C.  J«— EzperieQces  Conceniiiig  the  Pgychic  Life 

of  the   Child,   Andlftieal  Psychology,  translated 

by  Oonstanoe  Lmg,  HeflCat,  Tsfd  &  Co. 
MoU,  A.— The  Sexual  life  of  the  Child,  Maftmillan 

Go. 
Beitlei^   B.*-Eiiie   infantile    Sezualtheoria   luid    ihie 

Baaridinng  xur   Selbstmordqrmbolik.    ZeniralNatt 

fiir  PMychoamlys^  Bd.  n,  Hft  2, 1912. 
Watson,  J.  B.— Behavior,  Henry  Hok  &  Go. 


CHAPTEBn 

Fiend,  S. — Das  Unbewnsst^  IntemaHonale  Zeitsekrift 

fir  AntUehe  PiyehomOyse,  Bd.  IIL,  Qd  4-5, 

1915. 

Do  YerdiSngnng,  Ibid.,  Hft  3. 

Znr  Einfiifarang   des  Narziasmns,   JahrbwA  der 

Psychoanalyse,  Bd.  VL,  1915. 

Einige  Bemerkongen  fiber  den  Begrifl  des  TJnbe- 

wnsBten  in  der  PsycSioanalyse,  Intematioiude  Zett- 

schrifi  fur  Arztliche  Psychoanalyse,  Bd.  I.,  Hit  2, 

1918. 

The  Interpretation  of  Dreams,  Chapter  TEI.,  The 

Maomillan  Co. 

The  FAyehqiMKtiboIogy  of  Ereryday  Life,  Macmil- 

Ian  Co. 
Frink,  H.  W.— What  is  a  Com]^exf  Journal  of  the 

American  Medical  Association,  Vol.  LXn.,  p.  897. 
Hart,  B. — ^The  Conception  of  the  Snbconscioas,  Jfow- 

nal  of  Abnormal  Psychology,  Vol.  IV.,  No.  6,  1910. 
*^The  Psychology  of  Insanity,''  Cambridge  Univennty 


Holt,  E.  B.— The  Freudian  Wish,  Heniy  BOt  ft  Co. 


BIBLIOGBAPHr  SB7 

Jones,  E. — ^The  Significance  of  tlie  Unconscioas  in 
Psychopathology,  Review  of  Neurology  and  Psy- 
ckiair^.  Vol  XIL,  No.  11,  1914. 

Pflster,  O.— The  Pfi^choanaljtic  Method,  Part  I,  Moffat, 
Taxd  &  Co* 

Putnam,  J.  J.^^Hunum  Motives,  Little,  Brown  ft  Co. 


CHAPTER  HI 

Abraham,  K.— Dreams  and  Myths,  Nervous  and  Men- 
tal Disease  Monograph  Series,  No*  XV» 

Blenler,  E. — ^Das  antistiche  Denken,  Jahrhuch  fur 
psychoanalytische  und  psychopathologische  For- 
sehungen,  Bd.  IV.,  Hft.  L,  1912. 

Brills  A*  A. — ^Dreams,  Chapter  II.  of  Psyehoanaiysis, 
iW.  B.  Satmders  Co. 

Ferenozi,  S. — ^The  Psychological  Analysis  of  Dreams, 
and  Stages  in  the  Development  of  the  Sense  of 
Beality,  Chapters  III.  find  YII.  of  Contribuiions 
to  Psychoanalysis,  Bichard  G.  Badger. 

Fread,  S.r— Formnlierong  fiber  die  zwei  Prinzipien  dea 
pqrchischen    Oescbehens,    Jahrhuch    fur  .psycho- 
ancdytische  und  psychopathologische  Forschungen, 
Bd.  ni,  Hft.  1, 1911. 
The  Interpretation  of  Dreams. 
On  Dreams,  The  Bebman  Co^ 
Die  Handhabong  der  Traumdentung  in  der  Psycho- 
analyse, ZentraXblatt  fur  Psychoanalyse,  Bd.  II, 
Hft.  3, 1912. 

Jones,  E. — ^Freud's  Theory  of  Dreams,  Chapter  XV 
of  Papers  on  Psychoanalysis,  William  Wood  &  Co. 

Jnng,  C.  G. — ^Concerning  Two  Bands  of  Thinking, 
Chapter  I.,  of  The  Psychology  of  the  Unconscious, 
Moffat  Ywd&Ca 


5SS  BIBLIOGBAPHT 

CHAPTER  IV 

Ferenczi  S. — ^Introjection  and  TransfereQce,  Chap.  IL  of 

Contributiang  to  Psychoanalysis. 
S*rend,  S. — ^The  Pcfychopathologj  of  Eveiyd^r  life,  ICac- 

millanCo. 
The  Interpretation  of  Dreams,  Chap.  V. 
Znr  I)ynani]k  der  Ubertragung,  Zentralblatt  fur  Psy- 

ckoanalyse,  YoL  IL,  1912. 
Hones,  B. — ^Papers  on  Pi^ehoanalysis,  Chapters  L,  IIL, 

XII.,  XIX.,  and  XX. 
Jung,  C.  G.— The  Significance  of  the  Father  in  the  Des- 
tiny of  the  Individual,  Chapter  in.,  Analytiedl  Psy- 

ehciogy,  Moffat,  Yard  &  Co. 
Pfister,  0. — ^The  Psychoanalytic  Method. 
Bank,  0.— Das  Inzest-Motiv  in  Dichtong  nnd  Ssg^ 

Denticke,  Vienna. 
Watson,  J.  B. — Behavior. 

CHAPTEB  V 

Brill,  A.  A. — ^Pgychoanalysis,  W.  B.  Sannders  Co. 

Cannon,  W.  B. — ^Bodily  Changes  in  Pain,  Hunger,  Fear 
and  Rage,  Appletons. 

Crile,  O.  W.— -Man,  an  Adaptive  Mechanism,  Maffmillnn 
Co. 

Darwin,  C. — ^The  Expression  of  the  Emotions  in  Man 
and  Animals,  D.  Appleton  &  Co. 

Bllis,  H. — ^The  Problem  of  Sexual  Abstinenoe,  Chapter 
VI.  of  Sex  in  Relation  to  Society,  YoL  VI.  of  the 
Studies  in  the  Psychology  of  Sex,  F.  A.  Davis  Co. 

Ferenczi,  S. — ^Introjection  and  Transference,  in  his  Ccm- 
tributions  to  Psychoanalysis,  Richard  G.  Badger. 

Freud  S. — Selected  Papers  on  Hysteria  and  other  Piqr- 
choneuroses.  Nervous  and  Mental  Disease  Mono- 
graph Series. 


BIBLIOGRAPHY  559 

Frmky  H.  W. — The  Freudian  Conception  of  the  Pgycho- 

neuroseSy  Medical  Record,  Nov.  29, 1913. 
Hitschmann,   B. — Freud's  Theories  of  the  Neuroses, 

Moffat,  Yard  &  Go. 
STones,  E. — ^The  Pathology  of  Morbid  Anxiety,  in  his 

Papers  on  Psychoanalysis. 
The   Belation   between  the   Anxiety  Neurosis   and 

Anxiety  Hysteria,  Journal  of  Abnormal  Psychology, 

Vol.  Vni.,  No.  1, 1913. 
Jung,  C.  G. — ^Analytical  Psychology,  Moffat,  Yard  &  Co. 
Seif,   L. — ^Zur  Psychopathologie   der  Angst,   Interna- 

iianale    Zeitschrifi   fur   arztliche    Psychoanalyse, 

Bd.  1, 1913. 

CHAPTER  VI 

Brill,  A.  A. — Anal  Eroticism  and  Character;  and  The 
Compulsion  Neuroses,  Chapters  IX  and  IV  of  his 
Psychoanalysis. 
Freud,  S. — ^Bemerkungen  liber  einen  Fall  Zwangsneu- 
rose,  Jahrb.  /•  psychoanal.  u.  psychopath.  Forsch., 
Bd.  I,  Eft.  2, 1909. 
Die  Disposition  zur  Zwangsneurose,  Int.  Zeit.  f .  a. 

Pqrchoanalyse,  Bd.  1, 1913. 
Das  TJnbewusste,  Int.  Zeit.  f .  S.  P.A.,  Bd.  IH,  1915. 
Triebe  und  Triebschicksale,  ibid.,  Bd.  Ill,  1915. 
Drie    Abhandlungen    zur    Sexualtheorie,    3d    edition, 
1915,  p.  54,  ff. 
Selected  Papers  on  Hysteria  and  other  Psychoneu- 
roses,  Chapters  V  and  VII. — Nervous  and  Mental 
Disease  Monograph  Series. 
Jones,  E. — ^Einige  Falle  Zwangsneurose,  Jahrb.  /.  p^- 
choanal,  u.  psychopath.  Forsch.,  Bd.  IV,  1912. 
Hass  und  Anal-erotik  in  der  Zwangsneurose,  ibid., 
Bd.  1, 1913. 


560  BIBU0GBAFH7 


CaiAPTEBYm 

Freud,    S.— Analyse   der   Phobie    anes   fun^ahrigen 

Esabeoi,    Jahrb.    f.    psychoawd.    u.    psychopaik 

Forsch.,  Bd.  I,  Hft  1, 1909. 
Die  YerdranganK,  Int.  Zmt.  f.  a.  PA.—Bd.  UI,  1915. 
Daa  UnbewuBBten,  ibid. 
DToneSy  E. — ^The  Relation  between  the  Anxiety  NenroBk 

and  Azixietjr  Hyateria,  Journal  of  Ahnormol  Pjy- 

ekologff,  Vol.  VIII,  No.  1, 1913. 
Stekel,  W.---Niervo6e  Angst^iistinde  und  ihie  Bdiand- 

longen,  Urban  &  Schwartssenberg,  Beilia. 


CHAPTER  X 

Buroow,  T. — The  Meaning  of  PQfdioanalyaia,  Journal 
of  Abnormal  Psychology,  Vol.  XII,  Ho.  l^  1917. 
Coneeptiona  and  Misconeeptiona  in  PfliyehoanaljM^ 
Journal  of  the  Amorieam  Madical  Anaeiaiion,  VoL 
LXVin,  Feb.  3, 1917. 
Dewey  and  Tofta— E  tibies,  Henry  Holt  &  Co. 
Ellia,  H. — Sexual  Education,  Chapter  II,  of  Sex  In  Re- 
lation to  Society,  Sixth  Volniae  of  the  Studiaa  in 
the  Piyehology  of  Sax. 
Freud,  S.— Weitere  RatoehlSge  zur  Tedmik  der  Psycho- 
analyse,  Nos.  I,  II,  and  m.  Int.  Zeit.  f.  a.  Piyeko- 
analyse,  Bd.  I,  II,  and  HI,  1913-16. 
Uber  ''wilde''  Psychoanalyse,  Zentratblati  f.  Payduh 

analyse,  Bd.  I,  1911. 
Origin  and  Development  of  Psychoanalysis^  Amerimm 

Journal  of  Psychology,  Vol.  XXI,  No.  2, 1910. 
History  of  the  Psychoanalytic  Movement,  Psyoko- 

analytic  Review,  Vol.  Ill,  No.  1,  191£. 
Beitrage   zur   Psychologic   des  Liebensldliens,   IL— < 


BIBUOGEAPHT  561 

Uber  die  aUgemeinste  Erniedrigang  des  Liebede- 

henB-^ahrbuch    f.    psyekoanal.    u.    psychopath. 

Forsch,  Bd.  IV,  Hft  I,  1912. 
Holt,  E.  B.— The  Freudian  Wish. 
Jones,  E. — The  Therapeutic  Action  of  PqrchoanalyBia, 

Chapter  XIY  of  Papers  on  Psychoanalysis.    See 

also  Chapters  XIX  and  XX. 
MacCurdy,  J.  T. — ^The  Ethics  of  Psychoanalysis,  Johns 

Hopkins  Medical  BuUetin,  1915. 
Beik,  T. — ^Einige  Bemerkungen  zur  Lehre  vom  Wider- 

stande,  Int.  Zeit.  f .  a.  Psychoanalyse,  Bd.  Ill,  1915. 
Watson,  J.  B.^Behavior. 


/ 


INDEX 


Abonlimy  293 

Afareaetioiiy  408 

ActiTation  energy,  48 

AettTo  and  paasive,  208 

Active  and  paaaiTe  partial  im- 
pulaesy  12 

Affeet  and  idea  in  compnkion, 
274 

Affect  really  a  oonaeious  sen- 
sory perception  of  a  bodily 
state,  146n. 

Affect-Bom,  280 

Affects,  strangulated,  408 

Affeetivity  least  controlled  by 
foreconsdous,  75 

AggreesiTe  tendency,  12,  20 

Aim  and  object  of  holophilio 
impnlaesy  230 

Allerotic  phenomena^  16 

Ambivalence^  207 

Ampbierotie,  16 

Analysis,  a  brief,  83-88 

Anger,  261 

AntLTiviseetionism,  186 

Anxiety,  66,  262  n. 

Anxiety  Neurosis,  260 

Anxiety  Hysteria,  280 
commonest  of  all  p^yeboneu* 
roses,  430 

Ahxzett  Htstbia,  thb  Pbt- 
GBOUNiT  or,  430 

AnziErr  Htbteka,  ▲  Case  of, 
444 

Association,   random,   tbe   de- 
scendant of  tbe  repressed, 
84 
relevancy  of  tbe  apparently 

irrelerant,  87 
free,  method  of,  102 

Attention,  83 

Autoerotism,  14 


BebaTior,  explicit  and  implicit^ 

607 
Bebaviorists,  606 
Bisexual  tenden<7,  16 

Gannon,  265 
Catbartic  metbod,  498 
Censor,  48,  61 

activity  of,  same  as  tbat  of 
conscience,  62 

a    second,    between    forecon- 
conscious    and    conscious 
systems,  82 
Cbivalry,  138 

Cbristian  Science,  132,  133  n. 
Cloaca  tbeory  of  blrtb,  24 
Coitus,  21 

cbildren's  view  of,  26 
Compensation,  126 
Complex,  38,  506  n. 

doctrine  of,  400 

Zuricb  doctrine  of,  244 
Compulsion  Neurosis,  148,  280 

COHFULSIOll      NSUBOBIB,      PST- 

OHOLOOT  OF,  270 
C6MPUL8I0N  NEUB06I8,  A.  CA8B 

OF,  308 

Compulsive  acts,  two-sided,  206 
Compulsive  doubt,  273 
Compulsive  fear,  272 
Compulsive  ideas,  272,  204 
Compulsive  self-reproacb,  286» 

303 
Compulsive  tbSnkIng,  272 
Condensation,  100 
Conditioned  reflex,  107 
Oonfeasion,  306 
Confessions  of  patient  not  sog- 

gested,  300 
Conflict,  51 
Conscience,  40 


564 


INDEX 


"Omtigkn''  flnory  of  i^mf - 


GoBVcnioa  hywk&nik,  281 
Goioiter-MtiTatkM,  76 
Cril0»  264 

Cnriodtj  imipfiilM^  12,  18,  IB 
Guriottty  hnpnliw  In  oompul- 


Daj-dicamii^  80 
Defcnw  and  &lortloB 

UDM,   182 

Deprivation,  242 

•f  the 
76,81 

of,    is   dMB 
108 
DiMiro  and  fcnr,  266 
OfagBoatie    and   diaittt^grntlTo 
parta  of  annlytae  worie,  630 
Dii«iiiaa     of     wiab-fiilillmNKl» 

107 
Dlaiaiqgrati^    and   dIagwMlle 
parta  of  anmlytle  work,  680 
Di^^laocttcnl^  76,  118,  148,  488 

diifiiae,  166 
Diatoriiott,  107 
anomit     o^     govanad     faj 
of  fapnaai 
182 
Boobt,  ompalahv,  278 
Dramatization  117 


89 
Dnua,  HtB  ImagfaiaTj  fnttll* 

meat  of  n  wiik,  86 
rapraacntatiaB  In,  la  Indtoart, 

67 
gymhollawi  of,  analogoQa  to 

that  of  eartoona,  07 
maaitet  oontant  of,  106 
latent  oontMit  of,  106 
a  coinpiowuia   mwwd  vivo 

oppoaed    pa;fddo    rtuami^ 

106 
fdnctloB  of,  ISX 
the    via  regia  to  tlin 


Dream,  Gonttnned 

atanding    of    tlie    unoon- 
8cioiia»  122 
analyaia  of,  in  ^gyAoihenr 
peattci^  122 


Ednottiott,  17  n^  648 
Educative  fonctiott  n( 

anaiyaia,  649 
E^  ideal,  68 
ia  not  aaani^  nftallastanl 


ia  largely  fore6anaei0a%  61 


Ellifl,  £L,  266 

Bmotlon  n  alata  ^  prepand- 

■eaa  far  netton,  264 
End  pleaaore,  16 
Energy  of  aezoal 

eaajf  to  laptaai,  76 
Iki'irgi    of    eoaifniBiw 

torn  mliplaoed,  282 
Eroginova  aonca,  6 
Bithatia  loNee, 

16 
Ethical    foraab    tha 

nera  of,  16 
Ezfaifaitiaoiam,  1%  17 

Father  complex,  211 

Fear,   diffarenaa 

mal  and  moryd,  268,  26» 
morbid,  defined,  266 
ia  eonvavtod  deaire,  122 

IVminiam,  136 

Ferencd,  16,  802 

Vizatian,  280 

Fixed  idea%  272 

Foraaonaeloiiv  41 
Foreeonaeioiia  eyatem,  aaaA  of 

ego-ideal,  61 
Fqneonaelons  like  a  aeraaB  be- 
tween    Uneonadoua     and 
fiiinariionan<;nB»  71 
like  a  theatrical  manager,  73 
imperfectly    ceBiiola    affect- 
ivity,  76 


INDEX 


565 


Foiujuugeiew,  Contiinied 
laigely  made  up  ol  deaeend- 

snte  of  the  repmaed,  81 
not   all   content  of,  eligible 

lor  oonseioiiniMSy  82 
Fore-plea8ure«  15 
Free    association,    method    of, 

102 
Freud  quoted,  92,  96  b.,   210, 

242,  296 

CtaiiiuB  and  neoioaii,  136 
Guilty  lenee  of,  603,  604 
distortion  of  sense  of,  604  n. 

Habit  aad  tnstiiiet  compsred, 
606 

Habit,  signiflcanoa  of,  608,  616 
eq;aiyalent  to  resistance  or 
oomplez,  613 

Habits  that  function  indefi- 
nitely, 620 

Habits  of  thougbt  6nd  feelings 
622 

Hallucinatory  satisfaotloa  of 
widies»  91,  96 

Hate,  261 

Hippocrates^  1 

Holopbilic,  deflnitian  of  term, 
6n. 

Homophilic  tenden^,  16 

Homosexual,  16 

Hunger,  8 

Hysteria,  1 

Hysterical  Tomiting,  10 

Idea  and  affect  In  compulsion, 

274 
Ideas,  compulsive  or  fixed,  272 
Ideas  but  not  energy  of  sexual 

wisbee  confined  to  uneon- 

eciooe,  79 
Identification,  167 
Imago,  207 

Infantile  sexualil^,  8-21 
Infantile   sexual   theories^   21, 

80 
fading  of,  27 


Ijiferiority  feeling,  16S 
Inhibitory  tendencies,  17 
Instinct  a  creator  of  twislft, 

70 
Instinct  and  habit  oompaTsd^ 

606 
Integrations,  dumges  in,  647 
Bitrojection,  166,  167 
Xntroverrion,  238 


James>  William,  280,  266 
Jones^  Ernest,  40,  262,  26» 

Kissing,  10 

Kleptomania,  162 

Knowing,  intellectual,   ▼■.   !•» 

UTiag,  646 
no  ordinary   kind  of,  etaw 

the  patient,  647 

Latency  period,  16,  19 
Latent  content  of  dream,  106 
Latent  memories,  82 
Libido,  6,  14,  61 
Looking  and  showing  impulses, 

13 
I^eidag,  140 

Manifest  content  of  dream,  106 
Masculine  and  feminine,  298 
Masochism,  18 
Masochistic-sadistio      impulse, 

12,  17,  18 
Masturbatian,  20,  239  b. 
Mbohanismb  or  Pstohopath- 

OLOOIOAL  MinDTEBTATIOirB, 

124 
Mechanisms  of  peychoanal^tlo 

cure,  496 
ifind  not  to  be  defined  as  imly 

consciousness,  84 
Morbid  fear  defined,  266 
Morbid  fear,  two  origins  for, 

267 

Mareissism,  62 
Neurasthenia,  270,  480 


1 


566 


INDEX 


Nmirosii,  *  pre-Frendian  view 

of,  2 
Neorods  m  putiAl  f milure  of 

repreMion,  122,  270 
KCOWMU  AS  ▲  Wholx»  220 
Neorods   the  negauTe  of  tlie 

pervertion,  228 
NeuriDsia,  primary  and  aeoond- 

ary  funetioa  of »  240 
Kenrotie  qrmptonis,  are  unoon- 

■eiovs  meehaiilaiiSy  124 
Neurotic^  the,  has  learned  to 

loTe  too  soon,  235  n. 
Nearotie  unable  to  shake  off 

habits  of  childhood,  620 
Kearotic's  greater  tendency  to 

form  flzationB»  235  n. 
Nightmares,  122 

Object  loTe,  10 

Obsessions,  272 

ObsessiTe  fear,  272 

(Edipns  complex,  15,  19,  206  n., 
200 

Omnipotence  of  thought,  802 

Oral-erotic,  10 

"Order''  and  ''pattern"  of  in- 
stinct reiiezes,  607 

Ofcr-compensaticn,  130,  200 

0?er-determination  in  neurosis, 
220 

Panic,  431 

Paranoia,  56 

Partial  impulses,  12 

PassiTe  tendency,  20 

•Tattem"  and  •*ord«r«  of  in- 
stinct reiiezes,  507 

Penis  complex,  186 

Penis  theory,  24 

Periods,  three,  of  human  sex- 
ual deyelopment,  8 

Perversions,  13,  21 

PbobU,  271,  431 

Pleasure-sucking,  10 

Pleasure  thinking,  80 

Pleasure  thinking  the  more 
primltiTe,  01 


Polymorphous-perrerse,  13 

Pre-inhibitoiy  period,  8 

Primacy  of  genital  zone,  10 

Projection,  165 

Projection  ordinarily  *  def< 
mechanism,  156 

Pflychasthenia,  271 

Psychoanalysis,  educative  fnno- 
tion  of,  640 
dissolves  certain  moral  inhi- 
bitions, 650 

PSTOHOANiXTlIO  GUBB,  THB- 
OBT  AlVD  MBOHAHIBK  OF, 
406 

Psychoanalytic  cure,  theory  of, 
neglected  hfy  writers,  601 

Pqrchoana^ytic  tedmi^pie,  84 
changes  in,  407 

PSTCHOLOGT  OF   AlTXIBrT   HTB- 

TKBEA,  430 
PSTCHOLOCIT      OF      GOMPDLSIDK 

Nkubobib,  270 
Ptaychoneuroses,  21 
are  more  serions  f allurea  of 
of    the    foreconsdous    to 
control,  76 


Rapport,  103  n. 
Bationalization,   40,    176,    611 

n.  2 
Bationalization  of  anxiety,  430 
Reality  thinking,  80 
belongs    to    higher    psychic 

systems,  00 
an  ezperimental  paying  out 

of    accumulated    t<miyiA«^ 

04 
goal  of,  is  utiUty,  04 
Re-enactment  of  what  cannot 

be  remembered,  633 
Regression,  236,  244,  200 
Regression  is  from  present  to 

past    and    from    real    to 

imaginary,  238 
Repressed,  descendants  of,  75, 

81,  103 


INDEX 


567 


BepreMion,  46 
a  protecttTo  meoluuiiiiiiy  49 
brought    about    1^    foreoon- 

adouBp  61 
failure  of,  76 
failure  of,  a  conditioD  of  neu- 

rouBy  221 
primarily  affects  ideas,  144 
Besistance,  47 
overoomiiig  of,  identical  with 
flUing    of    menary    gaps, 
602,  617 
origin  of,  606 

might  be  caUed  habit,  606 
Betention  of  f eoes,  9 


Sadism,  13 
in     antivivisectionism     and 

chiyalry,  137  n. 
in  iTDching^  140 
unconscious,   causes   compul- 

siTe  self-reproach,  200 
repressed,  291 
Sadistic-masochistio      impulse, 

12,  18 
Sadistic  peirersion,  141 
Sadistic  impulse  in  compulsion 

neurosis,  300 
Secondary     defense     measures, 

296,  807 
Secondary  elaboration,  121 
Secondary  function  of  the  neu- 
rosis, 307 
Self-reproach,  compulsive,  286 
Sexual,  the  term,  3 
Sexual  emotion,  267 
Sexual  factor  in  neurosis,  223, 

309 
Sexual  ideal  in  neurotics,  234 
Sexual  instinct,  2 
development  of,  in  education, 

648 
Sexual  investigation,  22 
Sexuality,  human,  three  phases 

of,  8 
effort  to  overcome^  661 


Sexual  Stutbbbib,  1 

Sexual  theories,  infantile,  21 

Small  penis  complex,  186 

Subconscious,  277 

Sublimation,  19 

Sublimsition  a  kind  of  displace- 
ment, 146 

Substitute  activities,  282,  294 

Substitute  idea,  17 

Superstition  and  compulsion 
neurosis,  301 

Symbols  in  dream,  120 

Symbols  in  dream  not  labeled, 
102 

Syinptoms,  neurotic,  124,  277 

Synthesis,  sexual,  1 

Thbobt   Ain>   Mbohanism    of 

THE  PSTCHOANALTTIO 

Cube,  496 

lliing-ideas,  146 

Thinking,  compulsive,  272 
two  kinds  of,  89 

Thought,  omnipotence  of,  302 

Thumb-sucking,  9,  10 

Transference,  192 
positive  and  negative,  218 
not  created  by  analysis,  219 
the  most  important  problem, 

600 
as   a   re-living   of   complex- 
producing  experiences,  631 
phenomena,  640 

Trauma,  psychic,  498 

UirooNBOious,  The,  30 
Unconscious  is  prbnitive,  66 
Unconscious  has  no  regard  for 

reality,  66 
Unconscious  is  infantile,  66 
Unconscious   is   unorlented   in 

time,  67 
Unconscious  Is  instinctive,  68 
Unconscious  contains  no  inhi- 
bition, no  negation,  no  con- 
flict, 70 


568 


INDEX 


Uii«>iueioii8  has  free  access  to 
'motility    only     in    major 
psychoses,  76 
Unconscious  habits,  621,  545 
Utility    the    goal    of    reality 
thinking,  94 

Verbal  residues,  94 
Vomiting,  hysterical,  10 

Will,  "weakness  of,"  293 

Wish.  76 

Wish,  alone  represented  by 
pleasure  thinking,  94 

Wish  that  has  to  remain  un- 
conscious, 285 


Wish  exists  even  in  uncon- 
scious, 279 

Woman  suffrage,  136 

Word-ideas,  145,  146 

Worry  in  healthy  persons  an 
instance  of  imperfect  con- 
control  of  foreconscioufl,  75 

Worry  not  the  cause  of  insom- 
nia, 432  n. 

Worry  a  symptom  of  neurotic 
state,  433  n. 


Zones,  erogenous,  9,  11 
stimulation  of  penile  and  cli- 
toris, 11 


RETURN    BIOSCIENCE  «  NATURAL  RESOURCES  UBRARY 

TO»^    2101  VALLEY  UFE  SCIENCES  BUDG.    642-253 1 
LOAN  PERIOD  1 

« 


^  «  n 


ALL  BOOKS  MAY  BE  RECALLED  AFTER  7  DAYS 


■J 


DUE  AS  STAMPED  BELOW 


GUEr 


- — ■;  '2  tj  vjso 

IMMEDIATELY 


UNIVERSITY  OF  CAUFORNIA,  BERKELEY 
FORM  r40.  DDO.  50m.  1 1  /94  BERKaEY,  CA  94720 


.1 


&J^\ 


1    ■  ■  ■■ 


U.  C.  BERKELEY  LIBRARIES 

mim 


-  l(o!/^       ilMBunr 


/ft  :5  7- :; 


A-> 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

.     ••  -  * 


• »     •« 


■-  f"